ABSTRACT
Objectives: To study the development of Steinstrasse, after Extracorporeal Shock Wave Lithotripsy [ESWL], and methods of prevention and treatment
Patients and Methods: Forty six patients diagnosed to have Steinstrasse, all of them treated conservatively initially. But when there was failure of conservative treatment, further management was used ranging from repeated ESWL, percutaneous nephrostomy [PCNL], endoscopic manipulation and then open surgery, depending on degree of obstruction, infection, renal function and response to each method of treatment
Results: Conservative management was successful in 22 patients [47.83%], repeated ESWL in 10 patients [21.74%], PCN in 7 patients [15.22%], ureteroscopy in 6 patients [13.04%] and open surgery in one Patient [2.17%]
Conclusion: Steinstrasse will be prevented by optimum selection of patients and accurate stone targeting. Active treatment [like ESWL, PCNL and ureteroscopy] is indicated when there is obstruction, infection and renal damage