Microscopic and biochemical fertility characteristics of semen after shockwave lithotripsy of distal ureteral calculi

Purpose: To elucidate the frequency and adversity of the effects of shockwa ve lithotripsy (SWL) on the male reproductive system. We investigated the p ossible alterations in the quality of semen in patients treated by SWL for pelvic ureteral stones. Patients and Methods: The semen of 10 men was examined 1 day before and 5 a nd 90 days after SWL for distal ureteral stones, in accordance with the Wor ld Health Organisation guidelines. The results were compared with those fro m the semen samples of 10 healthy male volunteers undergoing SWL for calcul i of the upper urinary tract. Results: Microscopic analysis of the semen samples revealed a transient dec line in sperm density (24.7%), sperm motility (10%), sperm vitality (8%), a nd seminal fructose (27.5%) after SWL for distal ureteral stones. A distinc tly higher number of spermatozoa of pathological origin was detected after SWL in the same group. There was no trace of microscopic hemospermia before shockwave treatment, but it was detected in 90% of the patients with lower ureteral calculi after SWL. Macroscopic hemospermia was detected in two of these nine patients. No deterioration of the semen characteristics and no hemospermia was observed after treatment in the control group with upper ur inary stones. Conclusions: Our investigations confirmed a transient deterioration in seme n quality after SWL for distal ureteral calculi, whereas no deterioration w as observed after SWL for upper ureteral stones. Impaired sperm quality val ues returned to normal within 12 weeks after SWL, clearly indicating a dama ging effect of SWL on seminal vesicle or ejaculatory duct function. The ini tial procreative capacity was restored in all patients.