title: Can we predict the need for intervention in steinstrasse following shock wave lithotripsy?
abstract: BACKGROUND
  Steinstrasse (SS) is a known complication of shock wave lithotripsy (SWL). Although the majority of SS clears spontaneously, about 6% require intervention. This study was carried out to identify the factors that determine the need for intervention in SS.
  
  
  METHODS
  This was a retrospective study of all patients who developed steinstrasse following SWL at our center. They were divided into two groups: a) Those cleared spontaneously and b) Those required intervention. The two groups were compared with regard to demographic profile, stone factors and factors related to steinstrasse.
  
  
  RESULTS
  Out of 2436 cases of SWL, 89 (3%) formed steinstrasse. The majority of the patients (35%) who required intervention had stone sizes of 10-14 mm. Coptcoat type III steinstrasse required significantly more interventions for clearance (P= 0.001). The site and the size of the SS was not a predictor of intervention for SS.
  
  
  CONCLUSIONS
  Early intervention is warranted in patients with steinstrasse where the lead fragment is >5 mm (Coptcoat type III).
authors.affiliation: Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Chandan
authors.initials: C
authors.lastname: Phukan
authors.affiliation: Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: T J
authors.initials: TJ
authors.lastname: Nirmal
authors.affiliation: Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Cornerstone V
authors.initials: CV
authors.lastname: Wann
authors.affiliation: Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: J
authors.initials: J
authors.lastname: Chandrasingh
authors.affiliation: Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Santosh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Nitin S
authors.initials: NS
authors.lastname: Kekre
authors.affiliation: Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Antony
authors.initials: A
authors.lastname: Devasia
keywords: Interventions; shock wave lithotripsy; steinstrasse