Side effects of extracorporeal shock-wave exposure in patients treated by extracorporeal shock-wave lithotripsy for upper urinary tract stone.

The side effects of shock-wave exposure on patients treated by extracorporeal shock-wave lithotripsy were analyzed by measuring chemical substances including cell-escaped enzymes in the blood and urine. Free hemoglobin, glutamic oxaloacetic transaminase (GOT) and lactate dehydrogenase (LDH) increased as a function of shock-wave count. Total bilirubin, GOT and LDH reached a peak on the 1st postoperative day and decreased to pretreatment values by the 4th day. Creatine phosphokinase and myoglobin also significantly increased on the 1st postoperative day but returned to pretreatment levels by the 4th day. The urinary ratio of N-acetyl-beta-d-glucosaminase to creatinine significantly increased after treatment and was still high on the 4th day. These results suggest that significant hemolysis and myolysis developed owing to shock-wave exposure, and that the kidney was damaged to some extent. Therefore, these side effects must be taken into account in determining the dose and frequency of treatment.