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Related Experiment Videos

Lessons learned in patients with large steinstrasse.

J L Weinerth1, J A Flatt, C C Carson

  • 1Division of Urology, Duke University Medical Center, Durham, North Carolina.

The Journal of Urology
|December 1, 1989
PubMed
Summary
This summary is machine-generated.

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Managing large steinstrasse (stone chains) in the ureter requires prompt intervention. Combined percutaneous nephrostomy and ureteroscopic lithotripsy is effective for complex upper urinary tract stones.

Area of Science:

  • Urology
  • Nephrology

Background:

  • Large ureteral stones can form steinstrasse, a serious complication.
  • This complication can lead to significant morbidity, including infection and sepsis.

Purpose of the Study:

  • To analyze patient presentation, metabolic consequences, and diagnostic/therapeutic outcomes for steinstrasse.
  • To identify predisposing factors and effective management strategies for large steinstrasse.

Main Methods:

  • Retrospective review of 19 patients (25 ureters) with large steinstrasse.
  • Analysis of diagnostic modalities, predisposing factors, and treatment outcomes.

Main Results:

  • Many patients had few symptoms despite obstruction, decreased renal function, and infection.

Related Experiment Videos

  • Predisposing factors included large stone burden, bilateral treatment, and fragment migration.
  • Percutaneous nephrostomy and double pigtail stents alone were often insufficient.
  • Combined percutaneous nephrostomy and ureteroscopic lithotripsy proved most effective for refractory cases.

    • Conclusions:

    • Steinstrasse management requires a tailored approach, often involving combined therapies.
    • Early and effective intervention is crucial to prevent complications like sepsis.
    • Staged management with extracorporeal shock wave lithotripsy or percutaneous nephrolithotripsy may be necessary for complex cases.