Translation: Victoria Anatolyevna Shaderkina, urologist at the Severskaya Central District Hospital Outpatient Clinic. For most patients with large upper ureteral stones, shock wave lithotripsy (SWL) and ureteroscopic contact lithotripsy (URSL) produce comparable results, according to the March issue of Urology. "Our study showed that shock wave lithotripsy (SWL) and ureteroscopic contact lithotripsy (URSL) are comparable for most patients with large upper ureteral stones," said Dr. Ying-Huei Lee of Chi Mei Medical Center, Tainan. Dr. Lee and colleagues compared the efficacy and cost-effectiveness of shock wave lithotripsy (SWL) and ureteroscopic contact lithotripsy (URSL) in the treatment of large upper ureteral stones in 35 men and 7 women. The study authors reported that the mean treatment time, pain score on an analog scale, and hospital stay were significantly lower for shock wave lithotripsy (SWL) than for ureteroscopic contact lithotripsy (URSL). However, the study did not include data on patient satisfaction at the end of treatment. The report indicates that the effectiveness rates were similar for shock wave lithotripsy (0.61) and ureteroscopic contact lithotripsy (0.63). The cost of treatment was $1,637 for SWL and $2,154 for URSL. All patients in the shock wave lithotripsy group experienced severe hydronephrosis, which required additional surgical procedures for stone removal. In the ureteroscopic contact lithotripsy group, two patients required open ureterolithotomy (one due to ureteral perforation, the other patient due to the inability to remove the stone). The researchers concluded that "the success rates for shock wave lithotripsy (SWL) and ureteroscopic ureteral lithotripsy (URSL) are comparable. However, URSL is more invasive, requires a longer hospital stay, and has a longer postoperative pain period." Dr. Lee reports that most patients are more willing to choose shock wave lithotripsy (SWL) as a first-line treatment for upper ureteral stones only if they have not previously failed this treatment. The authors strongly recommend that cost-effectiveness, success rate, pain severity, and patient satisfaction be considered when choosing the optimal treatment method for patients with large upper ureteral stones.