Ureteric stones

Symptomatic ureteral calculi are common. While in many cases, spontaneous passage or medical expulsive therapy (MET) can avoid the need for surgical intervention, in others intervention is required to relieve ureteral obstruction and/or remove the stone. Important indications exist for immediate or urgent intervention to assure urinary drainage or to remove obstructing ureteral calculi. In the case of infection, the consequences of failure to relieve the obstructed ureter can include severe sepsis and death. For both emergent and urgent indications for urinary drainage, a ureteral stent or percutaneous nephrostomy tube may be considered first-line options. For those patients that require intervention to fragment and remove a ureteral stone, ureteroscopy, and shock wave lithotripsy are acceptable options. This chapter will review indications and techniques for relieving ureteral obstruction and removing the ureteral stone.