Tiny calculi impacted in the pelvic segment of the ureter can be as tantalizing to the physician as they are agonizing to the patient. As a rule these curious pseudogeologic formations should be removed as quickly as possible, before the onset of certain painful and dangerous complications and/or sequelae.
The trouble one may encounter in extracting a stone from the ureter varies greatly and is wholly unpredictable. Thus a relatively small stone may require open operation, while another much larger may respond favorably to the slightest manipulation. This unpredictable behavior doubtless is the fault of the ureter, which from the standpoint of biomechanical efficiency leaves much to be desired. It is too small in caliber, too fragile and too keenly sensitive to reflex stimuli. A combination of these and other faults makes the removal of a stone by manipulation one of the most uncertain and often one of the most
FINNEY RP. THE PRINCIPLE OF TRACTION IN THE TREATMENT OF URETEROLITHIASIS. JAMA. 1941;117(25):2129–2131. doi:10.1001/jama.1941.02820510017004
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