Steinstrasse CT KUB

This non-contrast CT study of abdomen for KUB of patient with left abdominal pain shows a dense large calculus in Urinary bladder which is in continuity with ribbon like column of multiple calculi in left ureter. 

Retrograde history taking unfurled that the patient had undergone ESWL one month ago.

Imaging diagnosis: Steinstrasse.

Steinstrasse is the German term which means "stone street", used to describe 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 couple of months after ESWL and the most common site is the distal ureter.

The 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. SOS more complex interventions such as stone flushing, ureteral dilatation, or long-term ureteral stenting may be required.