Steinstrasse

Last revised by Dr Mohammad Taghi Niknejad on 30 Nov 2021

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.

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.

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.

The term was coined by Egbert Schmiedt and Christian Chaussy, the German pioneers of ESWL in the 1980s.

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Cases and figures

  • Figure 1: Steinstrasse - illustrative photgraph
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  • Case 1
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  • Case 2
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  •  Case 3
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  • Case 4: Steinstrasse (stone street)
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  • Case 5
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  • Case 6
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  • Case 7
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  • Case 8
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  • Case 9
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  • Case 10: urethral steinstrasse
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  • Case 11
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  • Case 12
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  • Case 13
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  • Case 14
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