title: Quality of semen after extracorporeal shock wave lithotripsy for lower urethral stones.
abstract: OBJECTIVE
  We investigated whether extracorporeal shock lithotripsy (ESWL) of stones in the distal ureter can cause decreased in male fertility.
  
  
  METHODS
  In vivo and in vitro examinations were performed to clarify possible changes in semen after ESWL of lower urethral stones. For the in vivo examination semen from 10 patients was examined on the day before and 3 days after ESWL. For the in vitro examination semen from 12 healty volunteers was divided into 2 portions after ejaculation, with half immediately examined according to World Health Organization criteria and half directly exposed to the ESWL focus.
  
  
  RESULTS
  The in vitro and in vivo examinations revealed a decrease in sperm density and sperm motility after ESWL. Macroscopic analysis revealed hemospermia in 30% of the patients after ESWL compared to 0% before ESWL. In addition, after ESWL all patients had microscopic hemospermia 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, indicating at least a transitory decrease in male fertility may occur.
authors.affiliation: Department of Urology, Virchow Clinic of Humboldt University, Berlin, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Andreessen
authors.forename: M
authors.initials: M
authors.lastname: Fedel
authors.forename: F
authors.initials: F
authors.lastname: Sudhoff
authors.forename: R
authors.initials: R
authors.lastname: Friedrichs
authors.forename: S A
authors.initials: SA
authors.lastname: Loening
mesh_terms: D000328:Adult; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D012661:Semen; D013076:Sperm Count; D013081:Sperm Motility; D014514:Ureteral Calculi / Q000628:therapy*