Ultrastructural Changes on Sperm After Extracorporeal Shock Wave Lithotripsy in Patients With Distal Ureteral Stone

Sperm DNA damage and seminal oxidative status after shock-wave lithotripsy for distal ureteral stones

“…Although clinical and experimental investigations have suggested the safety of SWL, its possible effects on the male reproductive system are still not known. Furthermore, the literature contains a limited body of research with contradictory results on the possible effects of SWL on semen characteristic and gonads (10,11,(14)(15)(16)(17)(18)(19). Although Puppo et al (16) reported no adverse effect on male fertility, Andreessen et al (10) noted macroscopic and microscopic hemospermia and decreased sperm motility and sperm density.…”

“…Andreessen et al explained this mechanism as a breakdown of spermatozoa in the seminal vesicle (10). Although the extensive agreement in the literature is that SWL temporarily affects male fertility parameters in patients with lower ureteral stones, there are also some studies that report different results (17). Some studies have investigated the effects of interruption of the organogenesis of germ cells caused by the teratogenic potential of high-energy shock waves in a number of systems, such as in vitro effects of human spermatozoa (18).…”

Semen quality after extracorporeal shockwave lithotripsy for the management of lower ureteric stones: a review of the literature

“…The study group had significant decreases in sperm density ( P = 0.004) and motility ( P ≤ 0.001). The authors further examined the semen specimens under transmission electron microscope and detected anatomical damages in the sperm in five patients (33.3%) in the study group at 3 months follow‐up, based on which they postulate the possibility of long‐term testicular damage [8].…”

What is the Impact of Extracorporeal Shock Wave Lithotripsy on Semen Parameters? A Systematic Review and Meta-Analysis

“…Among its potential limitations is the fact that some published studies have raised concern regarding the potential side effects of high-energy shock waves on human tissue. In support of this concern, animal models have shown an acute, dose-dependent effect on tissue after exposure to shock wave energy (1, 2). Even so, researchers are still debating whether this technique produces clinically relevant, long-term effects on human tissue.…”

“…However, the number of studies is very limited that have investigated the possible effects of ESWL on the testes and the quality of semen, and even these studies have produced conflicting results (1–2–3–4–5–6–7–8). A few animal studies have been published (9, 10), and there have also been a few in vitro studies (11, 12) and clinical studies (3–4–5–6–7–8), but no systematic review or meta-analysis has been published in this area. Thus, we conducted a systematic review and meta-analysis to evaluate the characteristics of young men's semen before and after they were treated with ESWL for lower ureteral calculi.…”