Steinstrasse [stīn′shtra-se] is the German word for "stone street", describing a possible complication of extracorporeal shock wave lithotripsy (ESWL) for urinary tract calculi, wherein a column of stone fragments forms that blocks the ureter.
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Terminology
The term steinstrasse can equally, albeit is less commonly ascribed to a collection of stones in a tube or duct elsewhere in the body, such as the common bile duct.
Pathology
Steinstrasse usually develops 1 day to 3 months after stone fragmentation by extracorporeal shock wave lithotripsy (ESWL). The most common site of the column of stone fragments obstruction is the distal ureter (64%), followed by proximal ureter (29%), and mid ureter (8%) 2.
These days, refined extracorporeal shock wave lithotripsy technique has reduced the incidence of steinstrasse from 20% to 6% 2.
Treatment and prognosis
Usually, the stone fragments pass spontaneously, but in about 25% of patients, retrograde stenting may be required to release the ureteral obstruction until the stone fragments become displaced and pass.
In rare cases, more complex interventions such as stone flushing, ureteral dilatation, or long-term ureteral stenting may be required 3.
History and etymology
The term was coined by Egbert Schmiedt and Christian Chaussy, the German pioneers of ESWL in the 1980s.
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