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A I 0-mm calculus in the right lower ureter associated with proximal hydroureteronephrosis is best treated with ?

A
Extracorporeal shockwave lithotripsy
B
Antegrade percutaneous access
C
Open ureterolithotomy
D
Ureteroscopic retrieval
High-Yield Explanation
Ans. is 'd' i.e., Ureteroscopic Retrieval "Ureteroscopic stone extraction is highly efficacious for lower ureteral calcui" - Smith's Urology A ureteroscope is a long endoscope that can be passed transuretherally across the bladder into the ureter. The stones can be caught in baskets or endoscopic forceps. Those that cannot be removed baskets or endoscopic forceps, are fragmented using ureteroscopic lithotrites. Any renal calculi that is 4 mm or less in size, is allowed some time (approx. 4 weeks) to pass spontaneously. Indications for surgical removal of a ureteric calculus (Ref: Bailey & Love 25/e p1301) stone is too large to pass spontaneously urine is infected repeated attacks of pain and the stone is not moving stone is enlarging stone is causing complete obstruction stone is obstructing solitary kidney or there is bilateral obstructions.

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