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Technology to treat kidney stones has improved so much and open stone surgery which has all but vanished.  With the advent of shockwave lithotripsies, laser lithotripsy, percutaneous nephrolithotomy, and smaller digital ureteroscopes, we are upon the most advanced technological aspect in kidney stone treatment.  Which methods offer the best quality of life?

While shockwave lithotripsy use has declined in some areas of the world, it is still very much used in others. Many guidelines offer it as an alternative to ureteroscopy for stones in the distal ureter. There is clinical equipoise that ureteroscopy is better. This study will evaluate whether SWL of distal ureteral stones is non-inferior to ureteroscopy.

What is the best option for a 13-15 mm lower pole stone? Shockwave lithotripsy? Ureteroscopy? Percutaneous nephrolithotomy? This randomized prospective trial will help us answer this question with modern day technology and help us counsel our patients on the pros and cons of each modality.