QUALITY OF SEMEN AFTER EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY FOR LOWER URETERAL STONES

Purpose: We investigated whether extracorporeal shock wave lithotripsy (ESWL dagger) of stones in the distal ureter can cause decreased male fertility. Materials and Methods: In vivo and in vitro examinations w ere performed to clarify possible changes in semen after ESWL of lower ureteral stones. For the in vivo examination semen from 10 patients w as examined on the day before and 3 days after ESWL, For the in vitro examination semen from 12 healthy volunteers was divided into 2 portio ns after ejaculation, with half immediately examined according to Worl d Health Organization criteria and half directly exposed to the ESWL f ocus. Results: The in vitro and in vivo examinations revealed a decrea se in sperm density and sperm motility after ESWL, Macroscopic analysi s revealed hemospermia in 30% of the patients after ESWL compared to 0 % before ESWL, In addition, after ESWL all patients had microscopic he mospermia compared to 10% before ESWL.Conclusions: The in vivo and in vitro examinations demonstrated deterioration in semen quality. Sperm density and sperm motility returned to normal 3 months after ESWL, ind icating at least a transitory decrease in male fertility may occur.