Patients undergoing SWL for ureteric calculi in Nishi-Omiya Hospital, Japan, between January 1, 2013 and June 30, 2019, were screened for inclusion in this retrospective study. This study was approved by the Internal Review Board of Nishi-Omiya Hospital (approval no. #20191206-1). In total, 588 patients were initially included; 51 were excluded for the following reasons: ureteral stent or nephrostomy (n = 24); lack of follow-up (n = 13); multiple stones in 1 ureter (n = 9); and previous URS and/or SWL for the target stone (n = 5) (Fig. 1). Thus, 537 patients were included in the analysis. In total, 491 patients (91.4%) underwent computed tomography (CT) prior to SWL, but 46 patients did not.

Flow diagram outlining patient selection. URS ureteroscopy lithotripsy, SWL shock wave lithotripsy

The locations of ureteral stones were classified as proximal (U1), middle (U2), and distal ureter (U3). Patients were grouped according to the time to SWL as urgent (0–3 days), early (4–30 days), late (31–60 days), long-delayed (≥ 61 days), and asymptomatic (unknown). Ureteral wall thickness was measured at the stone site on preoperative non-contrast CT scans, as described previously [10].

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