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Eterović D et al, 2013: Wrong perspective obscures the adverse effects of shock-wave lithotripsy

Eterović D, Situm M, Marković V, Punda A
Department of Nuclear Medicine, University Hospital Split and Department of Medical Physics, University of Split Medical Faculty, Spinčićeva 1, 21000, Split, Croatia


Abstract

No abstract available.

Urolithiasis. 2013 Feb; 41(1): 89-90. doi: 10.1007/s00240-012-0519-6. Epub 2012 Dec 23
PMID:23532430 [PubMed - in process]

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Hans-Göran Tiselius on Monday, 29 October 2012 06:24

The authors claim that vascular effects of SWL is not appropriately recognized and that "mild and unilateral renal obstruction" following SWL has serious adverse effects on renal function, and that such effects were not seen following stone removal by open pyelolithotomy.

It is known that SWL has effects on renal hemodynamics but also that in the majority of patients these effects seem to be transient. Serious long-term renal damage is unlikely in view of more than 30 years of experience with SWL. Most studies have failed to demonstrate development of hypertension and it is important to realize that also spontaneous passage of stones with ureteral obstruction my give similar effects on renal hemodynamics as those recorded by the authors. Whatever the long-term effects are they seem to of minor clinical significance. Moreover, repeated pyelolithotomy is definitely not without complications.

Hans-Göran Tiselius

The authors claim that vascular effects of SWL is not appropriately recognized and that "mild and unilateral renal obstruction" following SWL has serious adverse effects on renal function, and that such effects were not seen following stone removal by open pyelolithotomy. It is known that SWL has effects on renal hemodynamics but also that in the majority of patients these effects seem to be transient. Serious long-term renal damage is unlikely in view of more than 30 years of experience with SWL. Most studies have failed to demonstrate development of hypertension and it is important to realize that also spontaneous passage of stones with ureteral obstruction my give similar effects on renal hemodynamics as those recorded by the authors. Whatever the long-term effects are they seem to of minor clinical significance. Moreover, repeated pyelolithotomy is definitely not without complications. Hans-Göran Tiselius
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