Chain of Stones in Distal Ureter: Is there any Role of Open Ureterolithotomy in Era of Endourological Intervention?

With the advent of endoscopy, management of ureteral stones by ureteroscopy and laparoscopy led to apromptdecrease in the use of open approach [1] in 1982, Chaussy et al [2] introduced Shock Wave Lithotripsy (SWL), which is currently most extensively used for ureteral stone disease. This further reduced the indications for open ureterolithotomy. Open ureterolithotomy is now a second or third line option for treatment of ureteral stones. At fully equipped centres with expertise in surgical stone management, the rate of open surgery has been reported to be1.0 to 5.4% [3-6]. However, open surgery for ureteral stones may still be needed for multiple impacted ureteral stones with large stone bulk that are treated poorly by minimally invasive methods [3,7,8].