title: Treatment of steinstrasse by transureteral lithotripsy.
abstract: 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.
authors.affiliation: Department of Urology, Shaheed Beheshti Hospital, Yasuj University of Medical Sciences, Yasuj, Iran. smrrabani@yahoo.com
authors.forename: Sayed Mohammad Reza
authors.initials: SM
authors.lastname: Rabbani
mesh_terms: 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*