Background: Although burst-wave lithotripsy (BWL) and ultrasound-guided extracorporeal shock wave lithotripsy (US-guided ESWL) are used for ureteral stones, direct comparative evidence to guide optimal clinical choice between them is limited.This work aimed to compare the efficacy differences between BWL and US-guided ESWL in treating 5–10 mm ureteral stones. Methods: This retrospective study included 100 patients with 5–10 mm ureteral stones treated between January 2022 and January 2024. The patients were divided into two groups of 50 patients each on the basis of treatment modality: the BWL group and the US-guided ESWL group. Baseline characteristics were balanced and comparable between groups (p > 0.05). The efficacy and safety of the two therapies were systematically evaluated by comparing various indicators across both groups. Results: For ureteral stones measuring 5–10 mm, BWL demonstrated superior outcomes in terms of stone clearance rate (88.0% vs. 64.0%), reduced retreatment rates (6.0% vs. 24.0%) and treatment costs compared with US-guided ESWL. The BWL group also demonstrated greater improvements in postoperative pain, stone passage time and quality of life (85.5 ± 5.2 vs. 80.3 ± 6.7 points, all p Conclusions: For ureteral stones measuring 5–10 mm, BWL demonstrates significant advantages in key efficacy indicators. It should be considered the preferred treatment option.
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