Cost and efficacy of extracorporeal shock wave lithotripsy versus ureteroscopy in the treatment of lower ureteral calculi.

We retrospectively reviewed the extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy experience relative to cost and efficacy of a group of practitioners skilled in the use of both procedures for the treatment of lower ureteral stones. Although the initial success rate was higher with ureteroscopy, no significant difference could be found in final success or complication rates. The cost of ESWL was approximately 60% higher than that for ureteroscopy (mean $7,320.26 versus $4,568.47, p less than 0.005). Given the current restraints on resources, and the equal efficacy and morbidity of both procedures, ureteroscopy must be considered the procedure of choice in the management of lower ureteral stones.