Methods for Lithotripsy of Ureteral Calculi

The main methods for ureteral stone fragmentation include: 1. Extracorporeal shock wave lithotripsy (ESWL): Using a lithotripter to deliver shock waves externally to break up stones within the ureter. This method is suitable for small stones, such as those less than 1.5 cm in diameter. 2. Pneumatic lithotripsy: Utilizing compressed air to drive a metal probe that physically impacts and fragments the stone. This method is suitable for stones of moderate size, but the fragmentation process is relatively slow. 3. Ureteroscopic holmium laser lithotripsy: After locating the stone with a ureteroscope, a laser is used to fragment it. This method is highly effective but involves an invasive procedure requiring hospitalization. 4. Percutaneous nephrolithotomy (PCNL): A nephroscope is inserted through the skin into the renal pelvis to locate and fragment the stone. This method is suitable for upper ureteral stones larger than 2 cm in diameter. 5. Open surgical stone removal: For patients with large stones that are impacted or lodged, open surgery may be required to remove the stone.