Shock wave lithotripsy has been utilized for the management of ureteral calculi since its introduction in the 1980s, although historically its use was limited to the treatment of proximal ureteral calculi. Currently, stones in all locations of the ureters can be treated successfully with SWL, albeit occasionally with the need for special positioning or use of ureteral catheters or intravenous contrast to facilitate localization. The feasibility and success of SWL for ureteral calculi are influenced by stone size, location, and composition, as well as on patient anatomy and comorbidities. Recent investigations have demonstrated that treatment parameters can be optimized and a variety of adjuvant measures can be utilized to enhance success rates and increase the safety of the procedure. Current guidelines endorse the use of SWL for the management of most patients with small-to-moderate-sized ureteral calculi.
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