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March 19, 1927


Author Affiliations

Washington, D. C.; Associate Professor of Genito-Urinary Surgery, Georgetown School of Medicine

JAMA. 1927;88(12):924. doi:10.1001/jama.1927.92680380004018c

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As a result of the improvements in urography made in the last few years, an increasingly large number of impacted ureteral calculi are being reported in the literature. It has been conservatively estimated that at least 90 per cent of all ureteral calculi may de demonstrated by careful roentgenography plus contrast pyelo-ureterography. In calculi that are deficient in lime salts and therefore possess poor shadow casting properties, a wax-bulb catheter may be used to corroborate the other observations.

Approximately 75 per cent of ureteral stones become impacted in the lower segment of the ureter, and it is this location that is most difficult to reach surgically. While the mortality from ureterolithotomy is low, the morbidity is less conducive to operative intervention except in those cases in which the ureter is blocked and the patient is very toxic.

Various nonoperative methods have been tried in removing these impacted

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