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
AuthorsMohammad H. Radfar, Nasser Simforoosh, Mehdi Sotoudeh, Mehdi H. Ramezani, Mohammad J. Mollakoochakian, Maryam Nikravesh, Hamidreza Shemshaki
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.
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.
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.
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.
- • Accepted on 28/10/2016
- • Available online on 02/12/2016
- • Published in print on 03/02/2017
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- Radfar, Mohammad H. [PubMed] [Google Scholar] 1
- Simforoosh, Nasser [PubMed] [Google Scholar] 1
- Sotoudeh, Mehdi [PubMed] [Google Scholar] 1
- Ramezani, Mehdi H. [PubMed] [Google Scholar] 1
- Mollakoochakian, Mohammad J. [PubMed] [Google Scholar] 1
- Nikravesh, Maryam [PubMed] [Google Scholar] 1
- Shemshaki, Hamidreza [PubMed] [Google Scholar] 1, 2, * Corresponding Author (firstname.lastname@example.org)
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