Steinstrausse - multilevel

Case contributed by Ian Bickle


Left sided flank pain and microscopic hematuria.

Patient Data

Age: 55 years
Gender: Male

Numerous small stones in the mid and distal left ureter, measuring upto 4mm.   The stones are stacked on each other in two separate portions at the mid pelvis and the VUJ.  At the VUJ the stack of stones protrudes into the intravesical segment of the ureter.

Moderate left hydronephrosis.

Bilateral renal cysts.

Case Discussion

A less commonly encountered form of urolithasis is steinstrausse when multiple stones stack up in the ureter, giving the impression of a cobblestoned street (in german - steinstrausse).

In this case there are two separate sections of steinstrausse at two levels in the same ureter.

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