THE ROLE OF PROSTANOIDS IN THE COMPLICATIONS OF EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY (ESWL) IN CHILDREN

ESWL is a safe and effective first-line treatment for urinary tract st one disease (UTSD) in children. The major complications arising from t his procedure were upper urinary tract obstruction and ureteral colic. It was shown that prostaglandin synthetase inhibitors were effective in the treatment of urethral colic. The aim of this study was to measu re urinary and plasma prostaglandin E(2) (PGE(2))- and leukotriene C-4 (LTC(4))-like activity in the patients who underwent ESWL before and after the treatment and investigate the role of cyclooxygenase (CO) an d lipoxygenase (LO) products in early and late complications of ESWL. Urinary PGE(2)-like activity were increased 1 h after ESWL. (1.19 +/- 0.12 vs 1.59 +/- 0.15 g/ml, p < 0.02). The plasma values were decrease d significantly after the treatment (16.7 +/- 1.7 vs 11.6 +/- 1.2 g/ml , p < 0.005). Urinary and plasma LTC(4)-like activities were found to be significantly decreased in the post-ESWL samples (0.58 +/- 0.006 vs 0.39 +/- 0.04, p < 0.002; 8.6 +/- 0.9 vs 4.2 +/- 0.6, p < 0.001, resp ectively). In conclusion, ESWL may stimulate the release of PG from th e urinary tract resulting in increased peristaltism and the passage of stone fragments into the bladder. As this group of drugs has also nep hrotoxic effects, they can be given prophylactically only to selected patients.