“Distal stones we treat medically first, then with ureteroscopy. Proximal stones we usually treat with ESWL, sometimes percutaneous treatment, depending on the stone’s location and size. If the stone is very large and in a location where ESWL is less likely to be successful, you think harder about doing the percutaneous approach. We generally only use ureteroscopy on distal stones.
We do a lot of ESWL. There’s a tendency to do multiple ESWLs, even where the percutaneous procedure is equally appropriate and requires only one treatment. When you describe both procedures, patients decide ESWL sounds like a better way to go. ESWL is less traumatic and the results are good.”
Geoffrey Engel, MD
Elk Grove Village, IL