Blind basketing without fluoroscopy and guide wire cannot be encouraged as a treatment choice. Shock wave lithotripsy and ureteroscopy are both acceptable treatment choices. Open surgery should not be the first-line treatment for most patients. Shock wave lithotripsy and ureteroscopy are both acceptable treatment choices. A standard is the least flexible of the three, a guideline more flexible and an option the most flexible.
Options can exist because of insufficient evidence or because patient preferences are divided.
Reprinted with permission from the Report on the management of ureteral calculi. The American Urological Association Ureteral Stones Clinical Guidelines Panel. American Urological Association, Baltimore, Md., 1997. Smaller stones were defined in the report as those less than 0.5 cm in diameter. The panel recommends use of narcotic analgesics and nonsteroidal anti-inflammatory drugs to control pain in the interim before passage of the stone.