The Effect Of Shock Wave On Rabbit Ovary

Background:Urinary lithiasis is a common disease.We can choose ESWL,ureteroscopic lithotripy or classical open surgery to deal with distal ureteral stone.There is no controversy over male patients using ESWL,but the female patients,whose ovary would be exposed to shock wave energy during treatment of distal ureteral stone during ESWL,should be cautious.Till now,there is no comprehensive evidence-based meta analysis about the injury of adjacent organs during ESWL.Objectives:to study the adverse effect of shock wave on rabbit ovary at different distance from the focus.Method:25 female rabbits(2250-3000g) were divided into 5 groups.After anesthetized,put titanium clip direct or put titanium clip around the ovary in distance of 3 or 5 cm surgically.Put the animal on lithotriopter,used X-ray to confirm the titanium clip be in F2,and started shock waves attacking.The first group,ovaries were attacked directly on focus at 16KV,2000 shock number.The second and third group,ovaries were attacked at the same condition above,but the distance from the focus were 3cm and 5cm respectively.In the last two groups,ovaries were putted at the distance of 3cm from the focus, among them the fourth group using 18 kilovolts and 2000 shock number, the fifth group using 16 kilovolts and 3000 shock number.Took out the attacked ovary,observed it with naked eye and light microscopy, observed the pathological changes and analyzed the data.Progesterone and estradiol leveas were tested before and after the ovaries were attacked by shock waves in seven rabbits.Result:On gross examination,there was no remarkable pathologic changes in ovaries at the first three groups.Ovary hyperaemia and sub-capsular hematoma were found in the fourth and fifth group.All the ovaries attacked by shock waves were found discrete low-count parenchymal hemorrhage microscopically,but no structure damage was found.In the first group,the average number of red blood cells per high power field was 64-73.In the second and third group,the average number of red blood cells per high power field was 12-38 and 1-11 respectively.There was significant difference among three groups.In the fourth group the voltage was added to 18 KV,the average number of red blood cells per high power field was 56-128.In the fifth group,the shock number was added to 3000,the average number of red blood cells per high power field was 68-186.There was significant difference between the second group and the last two groups.Progesterone and estradiol levels were tested before and after the ovaries were attacked, there was no significant difference in two groups.Conclusion:The pathologic finding of the ovary following exposure to shock waves was only scattered low-count paranchymal micro-hemorrhage,no histological structure damage was found.The severity of the injury of the ovary on focus was higher than it near the focus,the injury of ovary at distance of 3 cm or 5 cm from the focus was much more slight successively.Ovary endocrine function before and after ESW was not changed.