What Is the Preferred Management of Lower Ureteral Stones? SWL or URS - A Critical Evaluation With an Emphasis on the Changes in Patient’s Quality of Life

Aim To compare the efficacy and safety of two treatment methods for lower ureteral stones: shock wave lithotripsy (SWL) and ureteroscopic treatment (URS), with a focus on the impact on patients' quality of life. Patients and Methods: A total of 174 patients with solitary radiopaque lower ureteral stones (5–10 mm) between July 2023 and October 2024 were treated with SWL (78 patients) or URS (96 patients). Stone-free (SF) status was evaluated at 3 months using Non-Contrast Computed Tomography (NCCT). Data included age, gender, stone size, and post-procedural analgesic requirement. Quality of life was measured using the Short Form-36 (SF-36) index. Results Although SF rates were higher in the URS group (96.9% vs. 84.6%), comparable SF rates for stones < 10 mm and symptom-free status during long-term follow-up suggest that SWL remains a valuable alternative. Additionally, 96.2% of patients expressed willingness to choose SWL again, highlighting patient satisfaction. SWL produced similar results to URS in physical functioning and general health, but URS showed better outcomes in pain and emotional well-being, possibly due to residual stone fragments. Conclusions SWL offers advantages such as shorter recovery times, reduced need for pain medication, and no requirement for general anesthesia, making it a preferred option for patients seeking non-invasive treatment. Both methods showed similar outcomes in quality of life, particularly in physical functioning and general health, demonstrating that SWL is an effective non-invasive treatment for lower ureteric stones.