Presentation
Peristent hematuria and left loin pain. Left hydronephrosis on ultrasound.
Patient Data
Multiple stones of varying size in the distal left ureter - the largest at the VUJ.
Left sided hydronephrosis.
The stacked up stones in the distal ureter resemble a cobbled stone street ( steinstrausse )
Case Discussion
Urolithiasis is common - with a significant component of this being ureteric stones.
Within this subset, the accumulation of numerous stones stacked up in the ureter is more unusual.
Typically the larger stone is the most distal, with the smaller stones stacking up proximally - the multiplicity may only be appreciated on 'windowing' of the CT-KUB study.
This appearance has been labeled as steinstrasse ( cobbled street ) due to its visual resemblance.
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