• Salman Manzoor, Altaf Hussain Hashmi, Muhammad Ali Sohail, Feroz Mahar, Shahid Bhatti, and Abdul Qayoom Khuhro.
• Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), Karachi. / Department of Urology, PMC Hospital, Nawabshah.
• J Coll Physicians Surg Pak. 2013 Oct 1; 23 (10): 726-30.

ObjectiveTo compare the stone free rate at one week after extracorporeal shock wave lithotripsy (ESWL) and ureterorenoscopic (URS) manipulation for proximal ureteric stone (10 - 15 mm size).Study DesignRandomized controlled trial.Place And Duration Of StudySindh Institute of Urology and Transplantation (SIUT), Karachi, from August 2010 to February 2011.MethodologyOne hundred and ninety patients with 10 - 15 mm proximal urteric stone, in each group were treated with ESWL and ureterorenoscopic manipulation by using an 8.0 or 8.5 Fr semi rigid ureteroscope. Intracorporeal lithotripsy was performed by using pneumatic lithoclast. The stone free rate were compared between groups by considering size of stone at one week after procedure. The success rate, retreatment rate, auxiliary procedure and complication rate were compared in each group.ResultsSuccess rate was 49.2% for ESWL and 57.8% for URS (p = 0.008). The re-treatment rate was significantly higher in ESWL group than in URS group (40% vs. 11 and 18% in URS group).ConclusionAlthough ESWL is regarded as the preferred choice of treatment for proximal ureteric stone, the present results suggest that ureterorenoscopic manipulation with intracorporeal lithotripsy is a safe alternative, with an advantage of obtaining an earlier or immediate stone-free status. Laparoscopic approaches are reasonable alternatives in cases, where ESWL and URS have failed.

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