Phull JS et al, 2015: How do we know what damage a safe intervention has in the long-term: Considering the risk of extra-corporeal shockwave lithotripsy and the onset of diabetes mellitus.
Phull JS, Aboumarzouk OM.
Department of Urology, University Hospital of Wales, Cardiff, UK.
Islamic University, College of Medicine, Gaza, Palestine.
No abstract available.
Urol Ann. 2015 Jul-Sep;7(3):365-6. FREE ARTICLE
This brief article is a summary of the authors’ speculation on the risk of developing diabetes mellitus as a consequence of SWL. This issue has been repeatedly discussed in several articles during recent years and the debate obviously continuous. The bottom-line of different reports so far is that SWL does not give rise to an increased incidence of diabetes mellitus. The present article has the character of an Editorial. The authors refer to a “current retrospective study with 15 years follow-up” in which it is claimed that endocrine effects of SWL have been demonstrated. Based on those results it was suggested that SWL might cause “occult pancreatic insult”. This article  cannot be found at indicated pages and my further attempts to find it have not been met with success. Either this article is not yet published or not included in PubMed.
It is of course always necessary to be aware of any long-term complications associated with SWL and then in particular the development of diabetes mellitus. It is of note, however, that the risk of developing diabetes in the population is in the range of 9-10% (mentioned by the authors).The prevalence of diabetes mellitus in patients with stone disease at the time of diagnosis was around 13-14% and at follow-up 20 years later 36% . That number should be compared with 33% of diabetes found in patients treated with SWL. In patients with metabolic syndrome a significantly increased risk was demonstrated with an average relative risk of 1.25. The highest relative risk can be expected in over-weight young women [3,4]. It stands to reason that with the high prevalence of diabetes mellitus in the population, minor differences related to pancreatic injury might be difficult to detect, but with a clinical experience of more than 35 years it seems unlikely that such a complication would pass undetected.
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