Ureteroscopy and stones: Current status and future expectations

Table 1 Advantages and disadvantages of different techniques[24]

	Contra-Indications	Advantages	Disadvantages
Percutaneous nephrolithotomy	Pregnancy, potential malignant kidney tumour, tumour in access tract area, atypical bowel interposition	Large renal and staghorn stones Able to remove large fragments Quicker large stone fragmentation and removal	Needs renal puncture plus dilatation Renal bleeding +/- embolisation Patient positioning (often prone) Requires a general anaesthetic (with risk in prone ventilation) Multiple days inpatient stay
Shock wave lithotripsy	Infection, pregnancy, arterial aneurysm, bleeding diatheses, distal ureteric obstruction	Non-invasive treatment Out-patient treatment No anaesthetic needed	Lower success rates Renal colic (secondary stone fragments) Steinstrasse May need multiple treatments Success rates less for lower calyx stones
Ureteroscopy	None	No incisions Day case procedure Can be used in pregnancy, obese and patients not suitable for prone position	Might require 2 operations for stone clearance May need a ureteric stent post op Ureteric avulsion/strictures Requires a general anaesthetic