title: Tissue effects of intracorporeal lithotripsy techniques during percutaneous nephrolithotomy: comparison of pneumatic and ultrasonic lithotripters on rat bladder.
abstract: The objectives of this study were to determine the tissue effects of ultrasonic and pneumatic lithotripsy on the rat urothelium. The rats were divided into three groups. Groups I and II consisted of ten rats each that underwent intracorporeal lithotripsy (pneumatic and ultrasonic lithotripsy, respectively). Group III contained ten control rats and no lithotripsy method was used, they served as references for absence of injury. The light microscopy findings were evaluated as follows: squamous metaplasia, papillary projection, inflammation, increased stratification, and stone formation. In five (71.4%) animals of group II, bladders were edematous and hemorrhagic, macroscopically. Histologically, the bladder wall was normal in four rats of group I and in one of group II. There was a significant increase in inflammation (31.5%), squamous metaplasia (85.7%), papillary projection (71.4%), increased stratification (71.4%), and microscopic or macroscopic stone formation (85.7%) in the bladder wall of group II rats in comparison with group I and control group. In the rat model, we noted that ultrasonic devices have a potential risk for tissue injury. In turn, this was associated with a markedly increased deposition of CaOx stones in the kidney. When confronted with harder stones, pneumatic lithotripsy can be more effective while also minimizing tissue injury.
authors.affiliation: Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Akif
authors.initials: A
authors.lastname: Diri
authors.forename: Berkan
authors.initials: B
authors.lastname: Resorlu
authors.forename: Muzeyyen
authors.initials: M
authors.lastname: Astarci
authors.forename: Ali
authors.initials: A
authors.lastname: Unsal
authors.forename: Cankon
authors.initials: C
authors.lastname: Germiyonoglu
mesh_terms: D000818:Animals; D008096:Lithotripsy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D051381:Rats; D017208:Rats, Wistar; D001743:Urinary Bladder / Q000293:injuries / Q000473:pathology*
references.citation: J Endourol. 2008 Feb;22(2):285-9
references.pmid: 18208361
references.citation: BJU Int. 2002 Jul;90(1):16-9
references.pmid: 12081762
references.citation: J Endourol. 2001 Nov;15(9):925-8
references.pmid: 11769848
references.citation: J Endourol. 1998 Apr;12(2):163-9
references.pmid: 9607444
references.citation: J Colloid Interface Sci. 2006 Aug 1;300(1):131-40
references.pmid: 16677664
references.citation: Urol Clin North Am. 1983 Nov;10(4):729-42
references.pmid: 6636386
references.citation: J Urol. 2002 Jan;167(1):31-4
references.pmid: 11743269
references.citation: Urology. 2010 Jul;76(1):247-52
references.pmid: 20022089
references.citation: Scand J Urol Nephrol. 1976;10(3):257-9
references.pmid: 1006190
references.citation: Int J Urol. 2008 Feb;15(2):115-20
references.pmid: 18269444
references.citation: J Urol. 2009 Aug;182(2):762-5
references.pmid: 19539311
references.citation: J Endourol. 1994 Aug;8(4):293-9
references.pmid: 7981740
references.citation: J Endourol. 2009 Oct;23(10):1663-8
references.pmid: 19785552
references.citation: Semin Urol. 1994 Feb;12(1):39-50
references.pmid: 8197336
references.citation: Urol Clin North Am. 1988 Aug;15(3):347-59
references.pmid: 3043864
references.citation: Urol Res. 2011 Jun;39(3):171-6
references.pmid: 20967435
references.citation: J Endourol. 2001 Nov;15(9):929-35
references.pmid: 11769849
references.citation: JAMA. 1985 Aug 23-30;254(8):1054-8
references.pmid: 4021044
references.citation: J Urol. 1995 Feb;153(2):535-7
references.pmid: 7815639
references.citation: J Urol. 2005 Jun;173(6):1991-2000
references.pmid: 15879803
references.citation: J Urol. 1998 Jan;159(1):17-23
references.pmid: 9400428