Objective: To define the therapeutic approach to ureteric stones.
Material and methods: 137 patients with 152 ureteric stones were treated between January 1990 and January 1997. Sixty seven stones (44%) were situated in the lumbar ureter, 16 stones (10%) were in the iliac ureter, 69 stones (46%) were in the pelvic ureter. These stones were treated by extracorporeal shock-wave lithotripsy (ESWL), ureteroscopy and, more rarely, ureterotomy.
Results: One hundred and three stones were treated in a single session, while 31 required two ESWL sessions. Treatment eliminated 82% of ureteric stones: 89% of lumbar ureteric stones, 31% of iliac stones and 85% of pelvic stones. Ureteroscopy was performed as first- or second-line treatment in 34 cases. It successfully treated 97% of ureteric stones: 100% of pelvic and lumbar stones and 91% of iliac stones. Three patients were successfully treated by ureterolithotomy for a lumbar ureteric stone and two for iliac ureteric stones.
Conclusion: SWL is the reference treatment for stones of the lumbar ureter. Ureteroscopy is justified after failure of ESWL for stones of the pelvic and iliac ureter, as it gives excellent results.