Kovačević Prstojević J. et al., 2024: Evaluation of Inflammatory Parameters Following Extracorporeal Shock Wave Lithotripsy (ESWL) and Ureteroscopy for the Treatment of Proximal Ureteral Stones.

Kovačević Prstojević J, Hasanbegović M, Alić J, Mišanović V, Lujinović A, Metović A, Krupić F, Miličić Pokrajac D, Hadžimuratović A, Zečević Pašić L.
Urology, Clinical Center University of Sarajevo, Sarajevo, BIH.
Pediatric Critical Care, Clinical Center University of Sarajevo, Sarajevo, BIH.
Human Anatomy, Faculty of Medicine University of Sarajevo, Sarajevo, BIH.
Biology and Human Genetics, Faculty of Medicine University of Sarajevo, Sarajevo, BIH.
Anesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SWE.
Pediatric Nephrology, Clinical Center University of Sarajevo, Sarajevo, BIH.
Clinical Biochemistry and Immunology, Clinical Center University of Sarajevo, Sarajevo, BIH.

Abstract

Introduction Inflammation can arise as a consequence of both extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy (URS) treatments. Alterations in inflammatory parameters may serve as indicators of kidney injuries and the ensuing inflammation. This study aims to investigate the effects of ESWL and URS procedures on inflammatory parameters for proximal ureteral stone treatment. Materials and methods A prospective interventional study comprised 120 patients with confirmed stones measuring less than 10 mm in the upper half of the proximal ureter. These patients were randomly assigned to either the ESWL or URS treatment groups. Laboratory analyses encompassed interleukin-6 (IL-6), leukocyte count, fibrinogen levels, and erythrocyte sedimentation rate (ESR), which were assessed prior to the intervention, on the first postoperative day, and six months later. IL-6 levels in the serum were determined using a chemiluminescence immunoassay (CLIA). Results There was no significant difference in IL-6 levels between pre-intervention and the first post-intervention day in patients treated with ESWL (1.8 (1.4-2.59) pg/mL vs. 2.33 (1.22-3.19) pg/mL). However, for patients treated with URS, the pre-intervention IL-6 value was 2.9 (1.9-3.34) pg/mL, and it increased significantly to 7.1 (3.85-28.07) pg/mL on the first post-intervention day (p<0.001). On the first post-intervention day, levels of IL-6, CRP, leukocyte count, and ESR were significantly higher in patients treated with URS compared to ESWL (p<0.001; p<0.001; p=0.03; p=0.03, respectively). Conclusion Our research findings suggest that monitoring IL-6 levels can offer valuable insights into the degree of inflammation and tissue damage during and following observed procedures, particularly among patients undergoing URS, even within the initial days post-procedure.

Cureus. 2024 Jan 8;16(1):e51882. doi: 10.7759/cureus.51882. eCollection 2024 Jan. PMID: 38327930 FREE PMC ARTICLE