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Extracorporeal Shock Wave Lithotripsy Induces the Release of Prostaglandins which Increase Ureteric Peristalsis
Author(s) -
HORGAN P. G.,
HANLEY D.,
BURKE J.,
COUSE N. F.,
FITZPATRICK J. M.
Publication year - 1993
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1993.tb16058.x
Subject(s) - peristalsis , extracorporeal shock wave lithotripsy , thromboxane b2 , ureter , medicine , prostaglandin , radioimmunoassay , urinary system , urine , endocrinology , alpha (finance) , thromboxane , prostaglandins f , lithotripsy , urology , surgery , platelet , construct validity , patient satisfaction
Summary— The aim of this study was to identify the changes in secretion of prostaglandins into the urinary tract as a result of treatment by extracorporeal shock wave lithotripsy (ESWL) and to determine their effects on ureteric motility. Sixteen patients with renal or upper ureteric calculi were studied. A peripheral blood and urine sample was collected immediately before and after ESWL, with further samples taken 24 h later. The following variables were assessed by radioimmunoassay: prostaglandin E 2 (PGE 2 ), prostaglandin F 1 α (PGF 1 α), and thromboxane B 2 (TXB 2 ). An in vitro canine study was then designed to study the activity of TXB 2 , PGF 1 α and PGE 2 on an isolated intact canine ureter model. Significant elevations of TXB 2 were found immediately after ESWL in both serum and urine, which fell almost to pre‐treatment levels by 24 h. PGF 1 α levels showed significant elevations at 24 h but no immediate increase as seen with TXB 2 . In contrast, PGE 2 levels were unchanged in the urine but significantly decreased in the serum. In vitro studies showed that both TXB 2 and PGF 1 α repeatedly produced an increased frequency of ureteric contraction. ESWL results in the release of prostaglandins from the urinary tract which are shown to cause increased ureteric peristalsis.