Treatment of steinstrasse by transureteral lithotripsy.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Rabbani
Sayed Mohammad Reza
SM
Department of Urology, Shaheed Beheshti Hospital, Yasuj University of Medical Sciences, Yasuj, Iran. smrrabani@yahoo.com
D000328:Adult; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D014514:Ureteral Calculi / Q000209:etiology* / Q000628:therapy*; D014517:Ureteral Obstruction / Q000209:etiology / Q000628:therapy; D014545:Urinary Calculi / Q000628:therapy*