The purpose of the study was to develop criteria for selecting a minimally invasive method of treatment in patients with ureterolithiasis. Urolithiasis is widespread in the modern population, while the proportion of ureterolithiasis in its structure is 20-50% according to different authors. The recommendations of the European Association of Urology identified the main approaches to the treatment of patients with ureteral stone, according to which extracorporeal shock wave lithotripsy and contact ureterolithotripsy should be considered alternatives. However, clear criteria for choosing each of these methods was not defined. Material and methods. 82 patients with proximal ureteral stone and 45 patients with distal ureteral stone were treated. The urinary passage through the urinary tract was normalized in all patients with proximal ureteral stone. The complete elimination of calculi-status “stone free” was achieved in 71 (86.6%) patients. There were residual fragments of stone with sizes less than 5 mm in the lower pole calyx of the kidney in 11 (13.4%) cases. The urinary tract patency was restored in all patients with a distal ureteral stone due to the complete elimination of stone fragments. Results and discussion. Based on the individual characteristics of ureterolithiasis, an algorithm for choosing a treatment method for this pathology is developed. We selected the main criteria of this algorithm, the size and localization of the stone, and the duration of obstruction. Extracorporeal shock-wave lithotripsy should be considered the first-line treatment when the calculus is located in the proximal ureter and the obstruction lasts less than 2 months. Сontact lithotripsy is the first technique for the distal ureteral stones, as well as stones in the proximal ureter with a duration of obstruction of 2 months or more. Conclusion. The combined approach including extracorporeal shock wave lithotripsy followed by endoscopic lithoextraction was supplemented by contact lithotripsy of large stone fragments if necessary. It was justified in the case of stones with sizes of 2 cm or more, regardless of their location. Percutaneous nephrolithotripsy is advisable if the stones are larger than 2.5 cm and an X-ray density of more than 1500 HU are located in the proximal ureter.

Keywords: ureterolithiasis, minimally invasive treatment, shock-wave lithotripsy, contact lithotripsy

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