Comparison of Efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) and Ureteroscopy for the Treatment of Proximal Ureteric Stone

Background: Proximal ureteric stones are a common urological problem requiring timely and effective management. Among the available interventions, Extracorporeal Shock Wave Lithotripsy (ESWL) and Ureteroscopy (URS) are two widely used techniques, each with its own advantages and limitations. Objective: To compare the efficacy of ESWL and URS in the treatment of proximal ureteric stones, defined by complete stone clearance on ultrasound three weeks post-procedure. Methods: This observational cross-sectional study was conducted at the Department of Urology, Balochistan Institute of Nephro-Urology, Quetta, over a six-month period. A total of 60 patients aged 17–60 years with single proximal ureteric stones (9–15 mm on CT KUB) were randomized into two groups: Group A (URS) and Group B (ESWL). All procedures were performed by a single experienced urologist. Stone-free status was assessed via ultrasound at three weeks post-intervention. Results: The stone clearance rate in the URS group was significantly higher (93.3%) compared to the ESWL group (60%) with a p-value of 0.003, indicating statistical significance. Complication rates were higher in the URS group, but generally mild and manageable. Conclusion: Ureteroscopy is significantly more effective than ESWL for the treatment of proximal ureteric stones, especially in cases with larger or harder stones. While ESWL remains a valuable non-invasive option, URS provides a higher stone-free rate and should be considered the preferred first-line treatment when appropriate.