Gulur DM et al, 2011: Semen quality after extracorporeal shockwave lithotripsy for the management of lower ureteric stones: a review of the literature.
Gulur DM, Philip J.
Department of Urology, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, UK.
Extracorporeal Shockwave Lithotripsy has long been an important tool in the urologists' armamentarium for the treatment of distal ureteric stones. Several studies have been conducted on the morbidity and adverse effects of ESWL on human tissues but the effect of lithotripsy on semen and testes remains inconclusive. Impact on semen analysis and testes is important because the seminal vesicles and testes are exposed to the shock waves due to their anatomical proximity to the distal ureter. This article has reviewed all the published literature in English language on semen analysis after lithotripsy.
© 2011 THE AUTHORS; BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.
BJU Int. 2011 Oct;108(8):1321-3. doi: 10.1111/j.1464-410X.2010.10008.x. Epub 2011 Mar 28
PMID: 21443655 [PubMed - indexed for MEDLINE]. FREE ARTICLE
The effects of shockwaves on semen quality have remained a matter of concern ever since distal ureteral stones were included as an indication for ESWL. The results of different studies have been difficult to interpret, particularly regarding the long-term effects of exposure to shockwaves. This review article summarizes all that has been published in this field so far.
Both seminal vesicles and to some extent testes are exposed to shockwave power when distal ureteral stones are treated. Accordingly decreased number of sperms and decreased sperm motility has been a general feature of the studies, but these alterations – in most examinations – seemed to be transient, with a normalization after 3 months.
Although the authors suggest larger studies with longer follow-up periods, the bottom-line of this literature review is that late effects are unlikely. A note of caution is, however, put forward for those men who already have semen with some quality problems.