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Abstract
Urinary stones have afflicted humankind since antiquity, with the earliest recorded example being bladder and kidney stones detected in Egyptian mummies dated to 4800 BC (1)=Clendening L et al = The prevalence of urinary tract stone disease is estimated to be 2% to 3% and, until the 1980s, urinary stones were a major health problem. (2)= Uribarri J et al = The management of urinary calculi has undergone dramatic changes since the early 1980s . The introduction of extracorporeal shock-wave lithotripsy (ESWL),and miniaturization of flexible and rigid ureteroscopes that was combined with the development of effective intracorporeal lithotriptors,including those utilising laser energy,the popularization of percutaneous nephrolithotomy (PNL),all these factors were of great achievement for the modern treatment of urinary calculi.
Furtherly,advancement in urologic laparoscopic surgery,has almost eliminated the need for open stone surgery .These relatively recent stone removal techniques have greatly improved the urologist’s ability to treat ureteral stones.
The main goal of surgical management of ureteral calculi ,is to achieve complete stone clearance with minimal morbidity to the patient.
Factors affecting ureteral stone management should be considered when deciding which treatment modality is preferable and may be conveniently grouped into three categories:
- Stone-related factors (stone location, size,composition, duration, and degree of obstruction
-Clinical factors (patient’s tolerance of symptomatic events, patient expectation, associated infection, single kidney, abnormal ureteral anatomy),
-Technical factors (equipment available for treatment, costs).
These factors may be referred to as treatment modifiers because the presence of one or more of these factors may shift the balance toward a certain treatment modality.