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<p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong style="mso-bidi-font-weight: normal;">Introduction:</strong><span style="mso-bidi-font-weight: bold;"> The aim of this study was t</span>o evaluate extracorporeal shock wave lithotripsy (SWL) outcomes as a solo therapy in patients with upper ureteral calculi and varying degrees of hydronephrosis.</span></span><span style="background: yellow; mso-highlight: yellow;"><br /></span><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong style="mso-bidi-font-weight: normal;">Materials and Methods<span style="mso-bidi-font-weight: bold;">:</span></strong> Eighty patients with upper ureteral calculi and a body mass index between 19.5 kg/m² and 22.5 kg/m² were included. They were categorized into 4 groups according to the severity of hydronephrosis as seen on ultrasonography and intravenous urography: group 1, no dilatation; group 2, mild dilatation; group 3, moderate dilatation; and group 4, severe dilatation of the pyelocaliceal system. The size of calculi, time to calculus clearance, success rate of solo SWL, and the need for additional therapeutic methods were recorded and compared between the four groups of patients. </span></span></p><p class="MsoBodyText2" style="margin: 0cm 0cm 0pt; line-height: normal;"><span style="font-family: Times New Roman;"><strong><span style="font-size: 12pt; mso-bidi-font-weight: bold;">Results:</span><span style="font-size: 12pt;"> </span></strong><span style="font-weight: normal; font-size: 12pt; mso-bidi-font-weight: bold;">The median size of the calculi was 13.5 mm, and the mean time to calculus clearance was 56.0 ± 24.2 days. In 71.3% of the patients, solo SWL was successful in the treatment of the calculi. Twenty-three patients required other therapies including double-J stenting, ureteroscopy, and nephrolithotomy. The patients without hydronephrosis and those with severe hydronephrosis (groups 1 and 4) showed a significant difference in the days to clearance of the calculus (mean, 31.7 days versus 85.6 days; <em style="mso-bidi-font-style: normal;">P</em> < .001).</span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong style="mso-bidi-font-weight: normal;">Conclusion<span style="mso-bidi-font-weight: bold;">:</span></strong> Patients with upper ureteral calculi and mild hydronephrosis can be effectively treated with solo SWL therapy. In those with moderate hydronephrosis, clearance takes longer or requires secondary interventions. In patients with severe hydronephrosis, we recommend alternative/adjunctive procedures.</span></span></p>