Current concepts in achieving renal hypothermia during laparoscopic partial nephrectomy.

Although stone free rates were quite high in both size categories (95% versus 89%, respectively), retreatment rates were significantly higher in the larger stone group (45% versus 11%, respectively), translating into an efficiency quotient of 81 for treatment of stones ≤ 7 mm and 58 for stones > 7mm. Although this size cutoff was chosen randomly, it provides a reasonable algorithm to guide treatment of distal ureteral calculi when considering treatment with a third generation lithotripter. For stones ≤ 7 mm in size, ureteroscopy or in situ SWL are certainly reasonable treatment options. However, for stones > 7 mm in size, the high success rate and low retreatment rate of ureteroscopy makes this treatment option more attractive then SWL if an HM3 is not available.