Treatment of Steinstrasse by transureteral lithotripsy

ABSTRACT

Extracorporeal shock wave lithotripsy [SWL] is an essential treatment for urinary calculi, but Post=SWL steinstrasse is a potential complication, especially in large-burden calculi. Our purpose was to evaluate the efficacy of transureteral lithotripsy [TUL] in the treatment of Steinstrasse caused by SWL. Twenty-four patients with Steintrasse following SWL were treated by TUL. The length of Steinstrasse varied from 1.5 cm to 6 cm. The patients were followed up after TUL and failed treatment was considered if the Steinstrasse was not cleared within 6 weeks. Fourteen patients [58.3%] became stone free, of whom 8 had a double-J stent before SWL. Partial response was seen in 6 patients [25.0%]. The remained 4 patients [16.7%] with failed TUL underwent open ureterolithotomy. One patient developed nonfunctioning kidney during the follow-up. Transureteral lithotripsy was successful in 6 out 8 patients with type 1, 8 out of 12 with type 2, and none of those with type 3 Steinstrasse. All of the successful cases of TUL were in the patients with lower ureteral calculi. Successful treatment of Steinstrasse by TUL can be achieved in less than two-thirds of the cases. Type and location of Steinstrasse may influence the outcomes. This complication seems sometimes to be troublesome and may even cause kidney loss