The steinstrasse: a legacy of extracorporeal lithotripsy?

32 steinstrasse formations in the first 600 extracorporeal shockwave lithotripsy treatments required intervention. Their radiological appearance has been classified into 3 types and the aetiology of each type is discussed. 24 cases received a primary needle nephrostomy to relieve obstruction and of these 18 passed spontaneously, 5 required ureteroscopic manipulation and 1 underwent open surgery. Primary ureteroscopic removal was successful in 3 out of 5 cases. 3 upper ureteric steinstrassen were removed by a percutaneous intrarenal approach. A suggested plan of management for complicated steinstrassen is outlined.