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Surgery General 390fc562

Which of the following is the treatment of choice in a patient with a 10-mm calculus in the right lower ureter associated with proximal hydroureteronephrosis?

A
Open ureterolithotomy
B
Ureteroscopic retrieval
C
Antegrade percutaneous access
D
Extracorporeal Shockwave lithotripsy
High-Yield Explanation
Calculi smaller than 0.5cm are likely to pass spontaneously in urine. Since the size of the calculi in this patient is large and is completely obstructing the ureter resulting in hydronephrosis, the treatment of choice would be ureteroscopic stone removal. In this procedure, a ureteroscope is passed transurethrally across the bladder into the ureter and removes the stones impacted in the ureter. Ref: Bailey and Love's Sho Practice of Surgery, 24th Edition, Pages 11318-1323.

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