“Steinstrasse” or stone street after extracorporeal lithotripsy

Abstract

The aim of this work has been to check the frequency and to assess which manoeuvres are necessary in treating the steinstrasse after ESWL in situ. From September 1989 to May 1996, 2400 patients were treated with extracorporeal lithotripsy, 86 (3.6%) developed a steinstrasse in the days immediately after treatment. Only 40% of cases had specific urinary obstruction symptoms. In 52 patients (60%) the steinstrasse was spontaneously eliminated within 4 weeks, while in the remaining 34 an auxiliary treatment was necessary (second ESWL, percutaneous nephrostomy, ureteroscopic management). These therapies required further hospital admittance but didn't cause statistically significant differences in the stone-free rate at 6 months (96% and 97%, p < 0.001). Our experience would indicate that the incidence of steinstrasse after ESWL in situ is quite low (3.6%) and the necessity for auxiliary treatment is extremely rare (1.4%).