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Repeated ESWl Treatment on Steinstrasse
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KMID : 0358319950360050531
Abstract
We analyzed the incidence and treatment of steinstrasse in 470 patients (renal units-521 cases) who underwent ESWL treatment for renal stones using a Piezolith 2300 piezoelectric lithotripotr between April 1990 and July 1993.
Of 521 renal stones, a total of 44 cases (8.5%) developed steinstrasse. The most common location for steinstrasse was in the lower ureter (72.7%), followed by upper ureter (22.7%) and mid-ureter (4.6%(. In these 44 cases, stone fragments passed
spontaneously in 23 cases (52.3%) and mean duration to spontaneous passage was 15.7 days(range 1-43 days). Repeated ESWL was performed on steinstrasse in 20 cases. Successful treatment (no residual stone fragments in the ureter) was achieved in
18
cases
(90%) and the mean number of sessions was 1.3. There was no significant complication after repeated ESWL Only 2 patienets who failed ESWL treatment required open ureterolithotomy. The remained 1 patient with nid-ureteral steinstrasse underwent
ureteroscopic management.
With this result, repeated ESWL seems to be effective and safe in the treatment of steinstrasse which is not expected to pass spontaneously.
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