Cover Image

Predictors of intervention in Steinstrasse following shock wave lithotripsy (SWL)

CHANDAN PHUKAN AHINDRANATHPHUKAN

Abstract


Introduction Steinstrasse (SS) is a well
known complication of shock wave lithotripsy
(SWL)and occurs in 2-10 of
cases. The majority of SS clears spontaneously
whereas about 6 require intervention.
This study was carried out to
see whether the need for intervention in
SS could be predicted.Material and
method This was a retrospective study
spanning 6 years. It included all patients
who had steinstrasse following SWL at
our center. They were divided into two
groups A) Those who cleared steinstrasse
spontaneously and B) Those required
interventions. The two groups
were compared with regard to demographic
profile, stone factors and steinstrasse
factors. Steinstrasse was classified
according to Coptcoat classification.
Results Out of 2436 only 89 (3)
formed steinstrasse. The majority of the
patients (35) who formed steinstrasse
and who required intervention were in
the group 10-14mm. Coptcoat type III
steinstrasse required significantly
more interventions for clearance (p0.001).
The site and the size of the SS was not a
predictor of intervention of SS.Conclusions
Early intervention is warranted in patients
with steinstrasse where the lead fragment
is 5mm (Coptcoat type III).


Full Text:

PDF

References


Chaussy C, Schmiedt E, Jocham D, et

al: First clinical experience with extracorporeally

induced destruction of kidney

stones by shock waves. J Urol

;127:417

Coptcoat MJ, Webb DR, Kellet MJ,

Whitfield HN, Wickham JE. The steinstrasse:

A legacy of extracorporeal lithotripsy?

Eur Urol. 1988;14:93-95.

Goyal R, Dubey D, Khurana N et al.

Does the type of steinstrasse predict the

outcome of expectant therapy? Indian J

Urol. 2006;22:135-138.

Fletcher M, Dickinson I, Coptcoat MJ

et al. The combination of PCNL and

ESWL for the treatment of large renal

calculi. Br. J. Urol.1986; 58:581-583.

Fedullo LM, Pollack HM, Banner

MP, Amendola MA, Van Arsdalen

KN. The development of steinstrassen

after ESWL. Frequency, natural

history and radiologic management.

AM J Roentgenol 1988; 151: 1145-

Kim SC, Oh CH, Moon YT, Kim

KD. Treatment of steinstrasse with

repeat extracorporeal shock wave

lithotripsy: experience with piezoelectric

lithotripter. J Urol 1991; 145:

-491

M.A.B. Sayed, A.M. El-Taher,

H.A. Aboul-Ella, S.E. Shaker. Steinstrasse

after extracorporeal shockwave

lithotripsy: aetiology, prevention

and management. BJU International

; 88; 675-678

Al-Awadi KA, Abdul Halim H, Kehinde

EO, Al-Tawheed A. Steinstrasse:

a comparison of incidence

with and without J stenting and the

effect of J stenting on subsequent

management. BJU Int. 1999;84:618

-621.

Satar N, Doran S, Ozkeceli R,

Turkyilmaz RK.Treatment of multiple

small stone particles

(steinstrasse) in the lower ureter after

theextracorporeal shock wave

lithotripsy treatment. Tr J Med

Sci.1998;28:269-271.

Bhagat SK, Chacko NK, Kekre

NS, Gopalakrishnan G, Antonisamy

B, Devasia A. Is there a role for

tamsulosin in shock wave lithotripsy

for renal and ureteral calculi?J Urol.

Jun;177(6):2185-11 Madbouly K, Sheir Kz, Elsobky

E, Eraky I, Kenawi M. Risk factors

for the stone formation of a steinstrasse

after extracorporeal shock

wave lithotripsy. J Urol. 2002

Mar;167:1239–1242.

Ryan, P. C., Lennon, G. M.,

McLean, P. A. et al: The effects of

acute and chronic JJ stent Table 2

Showing the - Demographic profile

placement on upper urinary tract motility

and calculus transit. Br J Urol. 1994

Oct;74(4):434-439.

Abdulmalik M Tayib, Hisham A Mosli,

Hasan M Farsi, Mahmoud A Atwa, Hisham

A Saada. Five Years Experience in the

Management of Steinstrasse Post Shock

Wave Lithotripsy JKAU: Med. Sci 01/2008;

:71-79.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An Initiative of The Tamil Nadu Dr MGR Medical University