Serial Changes of Ultrastructure of Rabbit Ureter after the Shock Wave Lithotripsy

Sohn, Houng Gyu

Abstract

PURPOSE: Introduction of the shock wave lithotripsy (SWL) has provided an avenue for dealing with many urinary stones noninvasively. Although SWL has been known to cause pathologic changes in various organ, little is known about its effect on the ureter, the target organ in SWL of ureteral stones in situ. We sought to determine the short-term effects of SWL on the ureter`.
MATERIALS AND METHODS
We removed the left lower ureteral segments of 21 rabbits to serve as the control group and 2000 shocks were applied to the right lower ureters. Groups of 7 rabbits were sacrificed at 1, 3 and 5 days after shock wave exposure. The histomorphological alterations were examined under light and transmission electron microscopy.
RESULTS
The epithelial cells disclosed no change after shock wave application. Histologically the muscular layer was the most affected part of ureter. There was interstitial and intracellular edema on light microscopy and marked chromatin and mitochondrial changes at the subcellular level. The adventitial layer was also edematous. This changes were prominent on day 1 and 3 and returned to normal on day 5.
CONCLUSIONS
We conclude that electromagnetic shock waves produce reversible morphological changes in rabbit ureteric muscle.