Quality of Semen After Extracorporeal Shock Wave Lithotripsy for Lower Ureteral Stones

Abstract

The in vivo and in vitro examinations demonstrated deterioration in semen quality. Sperm density and sperm motility returned to normal 3 months after ESWL, indicating at least a transitory decrease in male fertility may occur.

Sperm DNA damage and seminal oxidative status after shock-wave lithotripsy for distal ureteral stones

“…In the past 20 years, the biologic effects of SWL have been intensively investigated (10)(11)(12)(13). In some of these studies, it was reported that shock waves applied at a therapeutic level of energy may cause double-strand DNA damage (12,13).…”

“…Although clinical and experimental investigations have suggested the safety of SWL, its possible effects on the male reproductive system are still not known. Furthermore, the literature contains a limited body of research with contradictory results on the possible effects of SWL on semen characteristic and gonads (10,11,(14)(15)(16)(17)(18)(19). Although Puppo et al (16) reported no adverse effect on male fertility, Andreessen et al (10) noted macroscopic and microscopic hemospermia and decreased sperm motility and sperm density.…”

“…But the mechanism responsible for the decrease in sperm concentration is not clear. Andreessen et al explained this mechanism as a breakdown of spermatozoa in the seminal vesicle (10). Although the extensive agreement in the literature is that SWL temporarily affects male fertility parameters in patients with lower ureteral stones, there are also some studies that report different results (17).…”

Extracorporeal Shock Wave Lithotripsy in Children

“…In men, distal ureteral ESWL has been shown to cause a transient but reversible impairment in semen quality [46,47,48]. Both microscopic and macroscopic hemospermia can be seen, as well as decreased sperm density and motility.…”

Early effects of extracorporeal shock‐wave lithotripsy exposure on testicular sperm morphology

“…The testes may be exposed to shock waves when ESWL is used to treat stone disease in the lower ureter and bladder. However, there is still controversy concerning the effects of shock waves on the testes and on male fertility (4,7). In this study, we investigated the in vivo effects of shock waves applied to the pelvic region on testicular histopathology and sperm morphology.…”