INTRODUCTION : The indications for intervention in the management of patients with ureteric calculi have clearly been affected by the increased efficiency and lower morbidity of minimally invasive treatment modalities. Although the traditional indications for intervention (intolerable or intractable symptoms, infection, obstruction, and a stone that is unlikely to pass spontaneously) have not changed, the array of technologies currently available allows almost any symptomatic patient to be considered a candidate for stone removal. Lingeman and associates reported that when a patient requires hospitalization, it is less costly to remove the patient's stone with either SWL or ureteroscopy than to attempt to control the patient's symptoms with pharmacotherapy only. However, many patients will pass the stone spontaneously. A thorough knowledge, then, of the natural history of ureteric stones permits a well-informed judgment of when conservative measures (e.g., observation), rather than intervention, are indicated. Furthermore, such data help the patient consider the spectrum of options and decide whether to try to endure further symptoms or to elect immediate stone removal. Continued studies are warranted to better define the roles of ESWL
and ureteroscopy in the management of patients with distal ureteric calculi because both are highly effective. AIM AND OBJECTIVES : The aim of this study is to 1) To analyze the efficacy of Extra corporeal lithotripsy in the management of lower ureteric calculus. 2) To find out ideal patients for extracorporeal shock wave lithotripsy in the management of lower ureteric calculus. 3) To find out complications of extracorporeal shock wave lithotripsy during the management of lower ureteric calculus. MATERIALS AND METHODS : Informed consent obtained from all the patients after explaining all available modalities of treatments–medical expulsion therapy, ureteroscopy & intracorporeal lithotripsy and extracorporeal lithotripsy, their complications in the management of lower ureteric calculus. CONCLUSION : 1. Insitu ESWL for lower ureteric calculus is an effective, non invasive and a viable treatment option with no major complications. 2. Patients with lower ureteric calculus size ≤ 10 mm and CT – H.U10mm and CT-H.U >1000. 4. Patients with lower ureteric calculus size > 10 mm and CT – H.U <1000, ESWL can be tried with reasonable success
