TY - JOUR T1 - Evaluating ESWL related alterations in renal pelvis and proximal ureter by analayting of tissue hydroxyproline levels AU - Şenyücel, Mine AU - Boybeyi, Özlem AU - Aslan, Mustafa AU - Soyer, Tutku AU - Balcı, Mahi AU - Demet, Arkut AU - Kısa, Ücler AU - Başar, Murad AU - Çakmak, Murat PY - 2015 DA - May JF - Deneysel ve Klinik Tıp Dergisi JO - J. Exp. Clin. Med. PB - Ondokuz Mayıs University WT - DergiPark SN - 1309-4483 SP - 31 EP - 34 VL - 32 IS - 1 LA - en AB - The aim of the study is to evaluate extracorporeal shock wave lithotripsy (ESWL)related alterations in renal pelvis and proximal ureter by using histopathological methodsand analayting hydroxy-proline levels. Twelve New-Zealand rabbits were allocatedinto two groups (n=6). Right sites of control group (CG, n=6) were harvested withoutany intervention. In ESWL group (EG), right kidneys of subjects were exposed to3000 shock waves (14 kV) by using electro-hydraulic type ESWL device three times.Rabbits in EG were sacrificed on day 7. Tissues were examined histopathologically forpresence of edema, inflammation, congestion, hemorrhage, fibrosis, vascularization andbiochemically for hydroxyproline concentrations. Histopathologically, tissue edema wasincreased in renal pelvises and inflammation was increased in ureters in the EG comparedto that in the CG (p<0.5). There was no difference in other parameters between the groups(p>0.05). Tissue collagen density did not show any significant difference (p>0.05). Therewas no difference in the tissue hydroxyl-proline levels of ureter samples (p>0.05). Tissuehydroxyproline levels were significantly higher in EG than CG in renal pelvis (p<0.05).In conclusion, although no major histopathological alteration due to ESWL was detectedin renal pelvis and proximal ureter, increased hydroxyproline levels in the renal pelviscan be suggested as a finding of tissue injury in collecting system. KW - Collecting system KW - ESWL KW - Hydroxyproline KW - Renal pelvis KW - Ureter CR - Baskin, L.S., Constantinescu, S.C., Howard, P.S., McAninch, J.W., Ewalt, D.H., Duckett, J.W., Snyder, H.M., Macarak, E.J., 1993. Biochemical characterization and quantization of the collagenous components of urethral stricture tissue. J. Urol. 150, 642-647. CR - Bergman, I., Loxley, R., 1970. New spectrophotometric method for the determination of proline in tissue hydrolyzates. Anal. Chem. 42, 702-706. CR - Carvalho, M., Freitas Filho, L.G., Carvalho, M., Fagundes, D.J., Ortiz, V., 2009. Effects of repeated extracorporeal shock wave in urinary biochemical markers of rats. Acta. Cirurgica. Brasileira. 24, 496-501. CR - Chaussy, C., Schuller, J., Schmiedt, E., Brandl, H., Jocham, D., Liedl, B., 1984. Extracorporeal shock-wave lithotripsy (ESWL) for treatment of urolithiasis. Urology. 23, 59-66. CR - Clark, D.L., Connors, B.A., Evan, A.P., Willis, L.R., Handa, R.K., Gao, S., 2009. Localization of renal oxidative stress and inflammatory response after lithotripsy. BJU. Int. 103, 1562-1568. CR - Finter, F., Rinnab, L., Simon, J., Volkmer, B., Hautmann, R., Kuefer, R., 2007. Ureteral stricture after extracorporeal shock wave lithotripsy. Case report and overview of the spectrum of rare side effects of modern ESWL treatment. Urologe. 46, 769-772. CR - Gnessin, E., Chertin, L., Chertin, B., 2012. Current management of paediatric urolithiasis. Pediatr. Surg. Int. doi: 10.1007/s00383-012-3096-4. CR - Goktas, C., Coskun, A., Bicik, Z., Horuz, R., Unsal, I., Serteser, M., Albayrak, S., Sarıca, K., 2012. Evaluating ESWL-induced renal injury based on urinary TNF-α, IL-α, and IL-6 levels. Urol. Res. doi: 10.1007/s00240-012-0467-1. CR - Klinge, U., Si, Z.Y., Zheng, H., Schumpelick, V., Bhardwaj, R.S., Klosterhalfen, B., 2000. Abnormal collagen I to III distribution in the skin of patients with incisional hernia. Eur. Surg. Res. 32, 43-48. CR - McAdams, S., Shulka, A.R., 2010. Pediatric extracorporeal shock wave lithotripsy: Predicting successful outcomes. Indian. J. Urol. 26, 544-548. CR - Minevich, E., 2010. Management of ureteric stone in pediatric patients. Indian. J. Urol. 26, 564-567. CR - Serel, T.A., Ozguner, F., Soyupek, S., 2004. Prevention of shock wave-induced renal oxidative stress by melatonin: An experimental study. Urol. Res. 32, 69-71. CR - Skolarikos, A., Alivizatos, G., Rosette, J., 2006. Extracorporeal shock-wave lithotripsy 25 years later: Complications and their prevention. Eur. Urol. 50, 981-990. CR - Somuncu, S., Caglayan, O., Cakmak, M., Caglayan, F., Ulusoy, S., 2006. The effect of indwelling catheter on OH-proline in the urethral wound: An experimental study. J. Pediatr. Urol. 2, 182-184. CR - Williams, C.M., Kaude, J.V., Newman, R.C., Peterson, J.C., Thomas, W.C., 1998. Extracorporeal shock wave lithotripsy: Long-term complications. Am. J. Roentgenol. 150, 311-315. CR - The increased level of OH-proline levels in renal pelvis in CR - EG may be an indicator of shock-wave induced tissue injury CR - in our study. The reason of the inability to confirm this injury CR - with histopathologic examination may be the close time CR - between shock wave exposure and tissue sampling. Some CR - studies showed that the initial renal damage resolves over CR - days to months (Williams et al., 1998; Carvalho et al., 2009). CR - Since we took the samples at 7th day we would be late to show CR - any histopathologic alteration in tissues. The increased level CR - of OH-proline in renal pelvis shows that damage had been CR - occurred after ESWL and the healing process started to take CR - place by increased collagen turnover. However, the effect of CR - this result to the long-term consequences of ESWL should be CR - examined in future studies. CR - In conclusion, although no major histopathologic CR - alteration due to ESWL was detected in renal pelvis and CR - proximal ureter, increased OH-proline levels in renal pelvis CR - can be suggested as a finding of tissue injury in the collecting system. UR - https://dergipark.org.tr/en/pub/omujecm/issue//217559 L1 - https://dergipark.org.tr/en/download/article-file/190428 ER -