I have a 5mm stone that is stuck in the ureter, just outside the bladder. it needs to be removed. i wanted to avoid the invasiveness of a cytoscope. is lithotripsy a good alternative? is it better to have lithotripsy or a cytoscope to remove the stone. li

Pt and MD preference: Though eswl is less invasive than ureteroscopy and cystoscopy, for the location of your stone ureteroscopy may be most effective and definitive treatment, if observation not option. Eswl works but it carries retreatment rate that is higher than ureteroscopy, meaning that you will need more that one treatment. Please consider need for further procedures when you discuss this with your urologist.

Two real options: You can either give time and use pain medications with tamsulosin. If this is not manageable for you, then the only intervention that should be recommended is a csytoscopy with ureteroscopy and stone removal. Good luck.

Distal stones: In general distal stones very near the bladder are best treated with cystoscopic and ureteroscopic extraction by basket. It is sometimes possible to target stones deep in the bony pelvis with lithotripsy although the success rate is variable and one still needs to pass the fragments once it is broken up.