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Background & Objective: Transureteral lithotripsy is an effective procedure in lower ureteral stone. This study was done to evaluate lithotripsy method in pediatric ureteral stones in Mashhad’s Imam-Reza Hospital. Materials & Methods: In our institute 38 patients went under ureteroscopy and lithotripsy for ureteral stones. Mean age in our patients was 6.8 years (Range 2-13 years). 16 patients were male and 22 patients were female. The mean stone size was 7 mm (Range 6-16 mm). Ultrasonography and KUB or IVP was performed in all cases. After general anesthesia and cystoscopy guide wire introduced in ureter, ureteroscopy were performed for lithotripsy used ultrasound pneumatic or electrohydrolic. Results: Stone were located in the distal ureter in 32 patients, in the midureter in 4 and in the proximal ureter in 2 cases. Ureteroscopy was successfully in 35 cases. Lithotripsy was used: Ultrasound, electrohydrolic or pneumatic. We were unable to introduce the ureteroscope into the ureter in 3 patients. In 3 patients stone migrated to the kidney after ureteroscopy. Then, they candidated for ESWL. Stone free was done in 32 cases (85%). A complication was 25% and treated with medical treatment. Conclusion: Our investigation demonstrates the high success rate ureteroscopy in pediatric group especially with a small caliber ureteroscope. Ureteroscopy should be considered the first choice for treatments of calculi in the distal ureter in children.

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Background and Objective: Lower ureter is the most common site of stone traped causing renal colic and hydroureteronephrosis. If medical therapy is not effective , the treatment consist of extracorporeal shock wave lithotripsy (ESWL), transurethral lithotripsy (TUL) or on rare cases, open surgery. This study was done to compare the ESWL with TUL in sixty patients with lower ureteral stones which did not responed to thraputic regiment. Materials and Methods: This prospective cohort study was done on sixty patients with obstructive lower ureteral stones for more than 3 weeks, that have not been responded to the thraputic regiment in Imam Reza hospital, Mashhad, Iran during 2004-06. According to treatment indications sixty patients divided in two equal ESWL and TUL groups. Success of procedure were evaluated by ultrasonography and KUB radiography. The success rate of two different technique and the side effects in each patients was recorded. Results: In ESWL group in 14 patients (46.66%) the stone was broken and its particles were removed but in 13 patients (43.33%) the stone was not broken and they became candidates for TUL. In 3 patients (10%) the stone was broken but the particles did not pass. The only complication of ESWL was renal colic which was in 15 patients (50%) and cured by medical treatment. In TUL group, in 93.5% of patients, the stone was broken and particles were removed, but in 6.5% the procedure was not successful and the patients underwented ESWL or open surgery. 10% of patients experienced fever and colic pain, who underwented medical treatment. Conclusion: This study showed that TUL technique has higher successful rate than ESWL technique in lower uretaral stones.