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What is the impact of extracorporeal shock wave lithotripsy on semen parameters? A systematic review and meta-analysis

What is the impact of extracorporeal shock wave lithotripsy on semen parameters? A systematic review and meta-analysis

Urologia 2017; 84(1): 28 - 34

Article Type: REVIEW

DOI:10.5301/uro.5000205

Authors

Mohammad H. Radfar, Nasser Simforoosh, Mehdi Sotoudeh, Mehdi H. Ramezani, Mohammad J. Mollakoochakian, Maryam Nikravesh, Hamidreza Shemshaki

Abstract

Background

Extracorporeal shock wave lithotripsy (ESWL) is an important tool for the management of urolithiasis. The effects of shockwaves on tissues are established. The aim of this meta-analysis is to evaluate the microscopic semen characteristics of young men before and after ESWL treatment for lower ureteral calculi.

Methods

Literature searches were performed following the Cochrane guidelines. We conducted a systematic review and meta-analysis that included six trials that investigated the effects of ESWL on semen parameters, including sperm concentration, motility, and hematospermia. Meta-analyses were performed using fixed and random-effects models with tests for publication bias and heterogeneity.

Results

Significant worsening was detected in sperm concentration and motility after ESWL between case and control groups (mean difference -17.23, 95% confidence interval -22.53 to -11.93, p<0.00001, mean difference -10.82, 95% confidence interval -18.56 to -3.07, p = 0.006). Rate of microscopic and macroscopic hematospermia was significantly higher after ESWL between case and control groups [risk ratio (RR) 40.00, 95% confidence interval 10.11-158.30, p<0.00001, RR 14.33, 95% confidence interval 2.82-72.90, p = 0.001]. All parameters recovered after 3 months.

Conclusions

This study showed sperm concentration, motility, and rate of hematospermia (microscopic and macroscopic) were affected by ESWL that was used for the treatment of lower ureteral stone. Long-term studies with a focus on male fertility (i.e., pregnancy rates) after ESWL are warranted.

Article History

Disclosures

Financial support: The authors received no financial support for the research.
Conflict of interest: The authors declare that there are no conflicts of interest.

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Authors

Affiliations

  • Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran - Iran
  • Research Committee, Shahid Beheshti University of Medical Sciences, Tehran - Iran

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