Evaluation and Management of Ureteric Calculi in a Secondary Care Hospital in Northeast India: An Observational Study

Background and aim Ureteric calculi are a common urological condition that affects a large number of individuals globally. In Nagaland, Northeast India, the incidence is increasing, likely due to the consumption of high-fat, meat-based, and spicy foods. This study aims to evaluate and compare the clinical outcomes of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URSL) in the management of ureteric stones. Specifically, it assesses therapeutic outcomes and postoperative complications associated with each modality. Materials and methods This observational study included 101 patients with ureteric calculi measuring 5-20 mm. Diagnosis was established using X-ray of the kidneys, ureters, and bladder (KUB), ultrasonography KUB, or CT scan. Patients were treated with ESWL (n = 20, 19.8%) or URSL (n = 81, 80.2%). Preoperative assessments included hematological and biochemical profiling and serum creatinine measurement. Postoperative complications were documented. Ethical clearance was obtained from the Institutional Ethics Committee of Christian Institute of Health Sciences and Research (ref. no. 022/202223/IEC-CIHSR; registration no. ECNEW/INST/2020/782). Results The majority of patients were male (n = 72, 71.3%) and aged 30-50 years (n = 63, 62.4%). Flank pain was the most common presenting symptom (n = 88, 87.1%). ESWL was performed exclusively for proximal stones (n = 20, 100%), whereas URSL was used for both distal (n = 37, 45.7%) and proximal stones (n = 44, 54.3%). Stone-free rates were 18/20 (90.0%) for ESWL and 69/81 (85.2%) for URSL (p = 0.849). Postoperative complications occurred less frequently in the ESWL group (n = 1, 5%) than in the URSL group (n = 18, 22.2%). Conclusions ESWL is effective for proximal stones smaller than 10 mm, whereas URSL is effective for stones up to 15 mm, regardless of location. Both ESWL and URSL achieved high stone-free rates with acceptable postoperative complications, with ESWL showing slightly fewer complications for proximal stones and URSL demonstrating effectiveness for stones at all locations.