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 stone disease (UTSD) in children. The major complications arising from this 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 measure urinary and plasma prostaglandin E2 (PGE2)- and leukotriene C4 (LTC4)-like activity in the patients who underwent ESWL before and after the treatment and investigate the role of cyclooxygenase (CO) and lipoxygenase (LO) products in early and late complications of ESWL. Urinary PGE2-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 decreased significantly after the treatment (16.7 +/- 1.7 vs 11.6 +/- 1.2 g/ml, p < 0.005). Urinary and plasma LTC4-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, respectively). In conclusion, ESWL may stimulate the release of PG from the urinary tract resulting in increased peristaltism and the passage of stone fragments into the bladder. As this group of drugs has also nephrotoxic effects, they can be given prophylactically only to selected patients.
Gazi University, Faculty of Medicine, Department of Pediatric Nephrology, Ankara, Turkey.
E
E
Hasanoğlu
N
N
Buyan
I
I
Bozkirli
S
S
Ercan
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015232:Dinoprostone / Q000097:blood / Q000652:urine; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D007700:Kinetics; D017997:Leukotriene C4 / Q000097:blood / Q000652:urine; D008084:Lipoxygenase / Q000378:metabolism; D008096:Lithotripsy / Q000009:adverse effects*; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism; D011453:Prostaglandins / Q000502:physiology*
D011453:Prostaglandins; D017997:Leukotriene C4; D008084:Lipoxygenase; D011451:Prostaglandin-Endoperoxide Synthases; D015232:Dinoprostone