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