Parameters Influencing Renal Damage in Extracorporeal Shock Wave Lithotripsy: An Experimental Study in Pigs

Abstract

Domestic pigs were used as an animai model in experiments involving detailed pathologic examination immediately after extracorporeal shock wave lithotripsy (SWL) in-order to study the effects of shock wave number, focal pressure, and size on the extent of renal damage. All 41 animals were treated under general anesthesia and sacrificed after treatment. Twelve kidneys (Group 1) were treated with 2000 shock waves at 38 MPa; 12 kidneys (Group 2) were treated with 600 shock waves at 38 MPa, 11 kidneys (Group 3) were treated with 2000 shock waves at 62 MPa, 11 kidneys (Group 4) were treated with 600 shock waves at 62 MPa; and 7 kidneys (Group 5) were treated with 2000 shock waves at 40 MPa. On histopathologic examination, parenchymal lesions of various extents were seen in 10/12 (83%) kidneys of Group 1, 9/12 (75%) of Group 2, 11/11 (100%) of Group 3,9/11 (82%) of Group 4, and 5/7 (71%) of Group 5. From the results of our study and those of other investigators, we conclude that renal damage in SWL correlates with the number and energy of the shock waves and also with the focal size.