Effect of Shock Wave Lithotripsy on Urease-Positive Calculogenic Bacteria

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Abstract
Extracorporeal shock wave lithotripsy has been extremely effective in patients with infection-associated renal calculi. Given recent data regarding the adverse effect of shock waves on malignant cells, the possibility was raised that shock waves might also have an adverse effect on calculogenic bacteria. Accordingly, we studied the direct and indirect effects of shock waves on urease-positive bacteria. In all instances, shock wave lithotripsy had no effect on viability of a variety of bacteria. These results more strongly underscore earlier recommendations that patients undergoing lithotripsy should have sterile urine. In those instances in which infection stones are suspected, appropriate parenteral antibiotic therapy should be instituted in order to sterilize the urine and should be continued in the immediate postlithotripsy period.