SIDE-EFFECTS OF HIGH-ENERGY SHOCKWAVES IN THE HUMAN KIDNEY - FIRST EXPERIENCE WITH MODEL COMPARING 2 SHOCKWAVE SOURCES

The side effects of high-energy shockwaves (HESW) from two different s ources on kidney parenchyma obtained from ill patients treated by radi cal nephrectomy for renal cell carcinoma were examined, Immediately af ter nephrectomy, the kidneys were perfused with cold HTK solution and kept in hypothermia (8 degrees C) for a maximum of 4 hours, In five ca ses, the tumor-free parenchyma was treated at the upper or lower renal pole with 2000 shocks, energy output 21 kV, in an experimental electr omagnetic shockwave system (Siemens Co., Erlangen), In the other five cases, the upper or lower poles were treated with 2000 shocks, energy output 24 kV, in an electrohydraulic spark gap system (MFL 5000; Dorni er Medizintechnik, Germering), The resulting tissue defects were analy zed by histologic examinations, Changes after treatment with the elect romagnetic system were found mainly in the tubules and midsized blood vessels in a well-defined focal area, Treatment with the electrohydrau lic system was followed by tubular and glomerular lesions combined wit h vessel defects in a patchy pattern. The model is able to define the side effects of HESW in the human kidney and to test the side effects of different lithotripters.