The treatment of ureteral stones has undergone a remarkable evolution in the last 15 years. Where at one time an open ureterolithotomy and stone basket manipulation were the mainstay of surgical stone management, they now have been superseded by an array of other modalities. Clinicians today can choose from stenting as definitive therapy, extracorporeal shock wave lithotripsy (ESWL, Dornier Medical Systems, Kennesaw, GA), percutaneous antegrade nephrostoureterolithotomy, retrograde ureteroscopy with or without intracorporeal lithotripsy, laparoscopic ureterolithotomy, and occasionally open ureterolithotomy. It has been suggested that with the newer less invasive forms of therapy a conservative approach is undertaken less often. This probably is increasing the proportion of all treated urinary stones that are ureteral at presentation.<sup>51 Marberger M., Hofbauer J., Turk C.H. , et al. Management of ureteral stones Eur Urol 1994 ;  25 : 265

Cliquez ici pour aller à la section Références</sup> Management issues today depend on the size, location, and composition of the stone; a patient's particular social and employment situation; the equipment available at a given institution; and the relative expertise of the treating urologist. In the current health care environment, the economic consequences for the hospital and the global health care budget also significantly affect treatment decisions.

The options available in 1996 for managing stones as they present in various locations within the ureter are considered (Figure 1). For the sake of discussion, the ureter is divided into its traditional thirds. The proximal ureter includes that portion that runs from the ureteropelvic junction to the upper part of the sacroiliac joint. The middle ureter overlies the sacral ala, and the distal ureter extends from the lower edge of the sacroiliac joint to the ureterovesical junction.