儘管體外震波碎石術(ESWL)早已風靡全世界，而其對腎臟結石和各個不同部位之輸尿管結石之療效更是眾所皆知，但是輸尿管鏡碎石術對中端和下端輸尿管結石之病例而言，仍是最佳的治療選擇。作者在127例接受輸尿管鏡碎石術的病患中，順利地為96例除去了結石，成功率為75.6％。假如結石之部位係在下端輸尿管，則成功率更高達89％。使用輸尿管鏡來取石或碎石必須極度小心，否則容易造成手術合併症。在127例當中，總共有25例發生合併症，其中22例均屬於輕度之輸尿管穿孔、尿路感染症或輸尿管黏膜裂傷，只須施以導管引流並配合服用抗生素即可解，不會造成諸如輸尿管狹窄之後遺症。對於上端輸尿管結石之處理，作者發現實施輸尿管鏡之時，太約有30％之結石會逆流至腎臟內，造成取石失敗。而體外震波碎石術對上端輸尿管結石之有效震碎率高達90％以上。有鑑於此，對這類結石之處理，以體外震波碎石術為最適當。使用輸尿管鏡取石的好處有 (一) 手術時間縮短 (二) 不須輸血 (三) 住院日數減少 (四) 成功率高 (五) 合併症少 (六) 術後休養期極短 (七) 不會在體表留下手術疤痕。我們認為操作醫師只要確實掌握某些特殊原則，輸尿管鏡處理輸尿管結石，必然是成功率高，合併症少，而值得推廣之手術。

Although extracorporeal shock wave lithotripsy (ESWL) has gained rapid populari-ty to treat urolithiasis at various locations, ureteroscopic stone manipulation (URS-SM) remains the method of choice in managing middle and lower ureteral stones. The suc-cess rates were 75% and 89% respectively for middle and lower ureteral stones. Early complications arising from URS-SM was not uncommon which occurred in 19.7% (25/127) of total cases, nevertheless, the vast majorities (22/25) were minor complica-tions such as small ureteral perforation, urinary tract infection and mucosal laceration. There was no stricture formation in our series observed up to 20 months. The high success rate as well as reduced morbidity and shortened hospital stay attained by URS-SM made it the advocated procedure for the treatment of middle and lower ureteral stones. Whereas, because of frequent backward migration of the stone during ureteroscopy, ESWL is the treatment of choice for upper ureteral stones. (J Urol R.O.C., 2:402-408 1991)