Tissue Damage by Extracorporeal Shock Wave Lithotripsy Treatment in Patients with Urolithiasis: Clinical Evaluation

  • Masao Yokoyama
  • Ken Kitahara
  • Ryozo Yanagizawa
  • Fumio Shoji
  • Moriaki Osaka


Changes in several serum and urinary laboratory values were noted in 542 patients treated with the Dornier HM3 lithotripter. Transient decreases were noted in hemoglobin, total protein (TP), albumin, and blood urea nitrogen (BUN). Transient increases were noted in white blood cell counts, total bilirubin (T. Bil), creatinine (Cr), lactate dehydrogenase (LDH), creatine phosphokinase (CPK), and glutamic-oxalacetic transaminase (GOT). All of these serum values returned to normal within three months except for a decrease in serum creatinine in patients treated for ureteral stones.

Creatinine clearance (CCr) decreased transiently following extracorporeal shock wave lithotripsy (ESWL) while increases in urinary ß-2-microglobulin (ß2MG) and N-acetyl-ß-D-glucosaminidase (NAG) were noted. Gamma glutamyl transpeptidase (GTP) did not change.

This study documents that injury to renal and surrounding tissues does occur with ESWL. Although the effects of ESWL are reversible at three months, the number of shock waves administered during ESWL should be limited.


Shock Wave Shock Wave Lithotripsy Renal Stone Extracorporeal Shock Wave Lithotripsy Brush Border Membrane 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Chaussy C, Brendel W, Schmiedt E: Extracorporeally induced destruction of kidney stones by shock waves. The Lancet 2: 1265, 1980.CrossRefGoogle Scholar
  2. 2.
    Fuchs G, Miller K, Rassweiler J, et al: Extracorporeal shock wave lithotripsy: one-year experience with Dornier lithotripter. Eur Urol 11: 145, 1985.PubMedGoogle Scholar
  3. 3.
    Gravenstein JS and Peter K (eds): Extracorporeal Shock Wave Lithotripsy for Renal Stone Disease: Technical and Clinical Aspectts. Stoneham, MA: Butterworths, 1986.Google Scholar
  4. 4.
    Sofras F, Karayannis A, Kistakopoulos A, et al: Methodology, results and complications in 2,000 extracorporeal shock wave lithotripsy procedures. Brit J Urol 61: 9, 1988.PubMedCrossRefGoogle Scholar
  5. 5.
    Yokoyama M, Shoji F, Yanagizawa R, et al: Extracorporeal shock wave monotherapy on renal and ureteral stones. Jpn J Urol 78: 2079, 1987.Google Scholar
  6. 6.
    Drach GW, Dretler SP, Fair WR, et al: Report of the United States cooperative study of extracorporeal shock wave lithotripsy. J Urol 135: 1127, 1986.PubMedGoogle Scholar
  7. 7.
    Chaussy C, Schmidt E, Jocham D, et al: Extracorporeal shock Wave Lithotripsy: New Aspects in the Treatment of Kidney Stone Disease. Basel, Switzerland: Karger, 1982.Google Scholar
  8. 8.
    Niijima T, Isurugi K, Umeda T, et al: Clinical application of extracorporeal shock wave lithotripter. Jpn J Urol 76: 1460, 1985.Google Scholar
  9. 9.
    Ruiz-Marcellan FJ, Ibarz-Serujio L: Evaluation of renal damage in extracorporeal lithotripsy by shock waves. Eur Urol 12: 73, 1986.PubMedGoogle Scholar
  10. 10.
    Kishimoto T, Yamamoto K, Sugimoto T, et al: Side effects of extracorporeal shock wave exposure in patients treated by extracorporeal shock wave lithotripsy for upper urinary tract stone. Eur Urol 12: 308, 1986.PubMedGoogle Scholar
  11. 11.
    Zanetti G, Trinehieri A, Mandressi A, et al: Serum and urinary enzymes after ESWL. V World Congress on Endourology and ESWL. Cairo, 1987.Google Scholar
  12. 12.
    Das G, Birch B, Samuel C, et al: Clinical significance of urinary enzyme changes following ESWL. V World Congress on Endourology and ESWL. Cairo, 1987.Google Scholar
  13. 13.
    Saltzman B and Krongrand A: Enzymuria following extracorporeal shock wave lithotripsy. V World Congress on Endourology and ESWL. Cairo, 1987.Google Scholar
  14. 14.
    Woodruff RD and Kandel LB: Effect of ESWL on the kidney and adjacent tissues. In Kandel LB, Harrison LH, McCullough D (eds): State of the Art: Extracorporeal Shock Wave Lithotripsy. New York: Futura Publishing Co. Inc., 1987.Google Scholar
  15. 15.
    Brendel W: Effect of shock waves on canine kidneys. In Gravenstein JS and Peter K (eds): ESWL for Renal Stone Diseases: Technical and Clinical Aspects. Stoneham, MA: Butterworths, 1986.Google Scholar
  16. 16.
    Newman R, Hackett R, Senior D, et al: Pathologic effects of ESWL on canine renal tissue. Urology 29: 194, 1987.PubMedCrossRefGoogle Scholar
  17. 17.
    Kaude JV, Williams CM, Millner MR, et al: Renal morphology and function immediately after extracorporeal shock wave lithotripsy. AJR 145: 305, 1985.PubMedCrossRefGoogle Scholar
  18. 18.
    Baumgartner BR, Dickey KW, Ambrose SS, et al: Kidney changes after extracorporeal shock wave lithotripsy: appearance on MR imaging. Radiology 163: 531, 1987.PubMedGoogle Scholar
  19. 19.
    Rubin JI, Arger PH, Pollack HM, et al: Kidney changes after extracorporeal shock wave lithotripsy: CT evaluation. Radiology 162: 21, 1987.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Masao Yokoyama
    • 1
  • Ken Kitahara
    • 1
  • Ryozo Yanagizawa
    • 1
  • Fumio Shoji
    • 1
  • Moriaki Osaka
    • 1
  1. 1.Department of UrologyToranomon HospitalTokyo 105Japan

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