Over the course of treatment, the stone disintegrates into very small sand-like particles, which are then discharged by normal peristalsis. The effectiveness of ESWL depends largely on the composition and size of the stone, as well as the type of equipment used. Absolute contraindications for ESWL are pregnancy, urinary tract infection, uncontrolled bleeding and hypertension. Relative contraindications for ESWL are very large stones, severely dilated collecting systems, protein matrix stones, obese patients, and patients with pacemakers. Ureteroscopy Recommended for stones in the lower and middle third of the ureter.
Endoscopic retrieval involves retrograde visualization of the urinary tract through the urethra.
This is an in-patient procedure performed under general anesthesia. Stone free rates using endoscopy are usually very good, but effectiveness depends largely on the experience of the operator. Complications include inadvertent perforations, bleeding and stricture formation. PCNL is another form of endoscopic retrieval, which involves making a 1 cm opening to access the kidney. Generally, patients are hospitalized for several days and may have a nephrostomy tube left in the kidney during the healing process.