To evaluate the predlsposing factores and characteristies of the steinstrasse after ESWL and to suggest the proper management of it, we analyzed 1,144 urolithiasis patients who were managed by ESWL with the second generatin lithotripter, Siemens
Lithostar, at Seoul National University Hospital from March 1989 to October 1995. Steinstrasse developed in 72 patients with the incidence of 6.3% after ESWL. As the risk factor for developing steinstrasse after ESWL. Stone size and volume
significantly
influenced the development of steinstrasse (p<0.01, by student t-test), and multiple stones induced stedinstrasse more frequently than single stones (p<0.05, by chi-square test). Stones located at renal pelvis induced more steinstrasse after ESWL
than
calyceal stones or ureter stones (p<0.05, by chi-square test). Clinically, 61,1% of the patients who developed steinstrasse didn't have any symptoms or upper tract changes. Nineteen steinstrassde (26.4%) were resolved spontaneously without any
intervention, with the median duration of 12 dyas after detection of the steinstrasse. In 51 steinstrasse which was not resolved spontaneously or with severe symptoms. ESWL was perdformed resulting in sussessful resolution in 94.1% of the
patients.
These results suggest that expectiancy could be the first line strategy of the management of steinstrasse, and repeated ESWL could be recommended for patients refractory to expectancy and patients with severe symptoms.
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