Treatment of Kidney Stone Disease with a Ureteral (Ureteric) Stone

This protocol addresses kidney stone disease in the specific setting of a stone located within the ureter. Ureteral stones typically present with loin pain and vomiting, and may be associated with pyrexia; some patients are asymptomatic at presentation.

Active stone removal is indicated. The choice of removal technique is guided by stone characteristics — stone size and location within the ureter are the principal factors that determine which intervention is most appropriate. One technique is associated with a higher likelihood of achieving a stone-free outcome with a single procedure; specific patient factors can also influence which approach is prioritised.

The complete protocol specifies the full decision pathway, including technique selection for each clinical sub-scenario.

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References

  1. Patients with ureteral stones usually present with loin pain, vomiting and sometimes pyrexia, but may also be asymptomatic.
  2. Inform patients that ureteroscopy (URS) has a better chance of achieving stone-free status with a single procedure.
  3. Use URS as first-line therapy for ureteral (and renal) stones in cases of morbid obesity.
  4. Percutaneous antegrade removal of ureteral stones is a consideration in selected cases, i.e. large (> 15mm), impacted proximal ureteral calculi in a dilated renal collecting system, or when the ureter is not amenable to retrograde manipulation.
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