Management of lower and middle ureteral calculi "in situ" using the Dornier MFL-5000 lithotripter.

A new successful approach in treating lower and middle ureteral calculi in situ was undertaken utilizing the Dornier MFL-5000. From August 19, 1989 to February 7, 1990, 46 consecutive cases were treated representing 60 stones (54 lower, 6 middle). The average size of treated stones was 12 mm. Ten cases (21.1%) had two stones and two cases (4.2%) had three stones. Stones were not displaced and no ureteral catheter was used except in one case, a female, 28 years of age, with a lower ureteral stone, where the stone had to be displaced proximally using a double balloon ureteral catheter to follow FDA protocol in order to avoid the ovaries. Minimal IV sedation was required in 97.7% of the patients and only 2.1% required general anesthesia. Different positioning techniques were implemented. One (2.1%) out of 46 cases required retreatment. The average length of stay in the hospital was 1.2 days. No complications occurred to date. Follow-up, 48 hours post-treatment, revealed 94.6% stone-free. At 3 month's follow-up, 100% were stone-free.