Demir A et al, 2015: The histomorphological findings of kidneys after application of high dose and high-energy shock wave lithotripsy.
Demir A, Türker P, Bozkurt SU, İlker YN.
Department of Urology, Kafkas University, Medical School, Kars, Turkey.
Department of Urology, Namik Kemal University, Medical Faculty, Tekirdağ, Turkey.
Department of Pathology, Marmara University, School Of Medicine, Istanbul, Turkey.
Department of Urology, Anadolu Health Center, Kocaeli, Turkey.
INTRODUCTION: In this animal study, we reviewed the histomorphological findings in rabbit kidneys after a high number of high-energy shock wave applications and observed if there were any cumulative effects after repeated sessions.
MATERIAL AND METHODS: We formed 2 groups, each consisting of 8 rabbits. Group 1 received 1 session and group 2 received 3 sessions of ESWL with a 7 day interval between sessions, consisting of 3500 beats to the left kidney and 5500 beats to the right kidney per session. The specimens of kidneys were examined histomorphologically after bilateral nephrectomy was performed. For statistical analysis, 4 groups of specimens were formed. The first and second groups received 1 session, 3500 and 5500 beats, respectively. The third and fourth groups received 3 sessions, at 3500 and 5500 beats per each session, respectively. The sections were evaluated under a light microscope to determine subcapsular thickening; subcapsular, intratubular and parenchymal hemorrhage; subcapsular, intersitital, perivascular and proximal ureteral fibrosis; paranchymal necrosis; tubular epithelial vacuolization; tubular atrophy; glomerular destruction and calcification.
RESULTS: In histopathological examinations capsular thickening, subcapsular hematoma, tubuloepithelial vacuolisation, glomerular destruction, parenchymal hemorrhage, interstitial fibrosis, and perivascular fibrosis were observed in all groups. In statistical analysis, on the basis of perivascular fibrosis and tubular atrophy, there was a beats per session dependent increase of both.
CONCLUSIONS: The detrimental effects from ESWL are dose dependent but not cumulative for up to 3 sessions. Histopathological experimental animal studies will aid in understanding local and maybe, by means of these local effects, systemic effects.
Cent European J Urol. 2015;68(1):72-8. doi: 10.5173/ceju.2015.01.480. Epub 2015 Jan 23. FREE ARTICLE
What was the hypothesis? If studies like this are done, because registration of a new device requires animal studies it should be declared in the manuscript.