Effects of Holmium Laser Lithotripsy with F6.0/7.5 Ureteroscopy on Stress Response and Sperm Quality in Male Patients with Lower Ureteral Calculi

XU Huiyang; CHEN Bote; QIU Xiaofu

doi:10.3639/j.issn.2095-3097.2024.11.012

Abstract：Objective To analyze the effects of holmium laser lithotripsy with F6.0/7.5 ureteroscopy on stress response and sperm quality in male patients with lower ureteral calculi.Methods A total of 93 male patients with lower ureteral cal-culi admitted to the Department of Urology,The Affiliated Guangdong Second Provincial General Hospital of Jinan University from February 2021 to February 2024 were selected and divided into the study group(n=47,F6.0/7.5 ureteroscopy)and the control group(n=46,F8.0/9.8 ureteroscopy)by the random number table method during holmium laser lithotripsy.The surgical indexes,stone-clearing effect,renal function[blood urea nitrogen(BUN),serum creatinine(Scr),cystatin C(CysC)],inflam-matory response indexes[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],oxidative stress indexes[cortisol(Cor),norepinephrine(NE),malondialdehyde(MDA)],sperm quality,and complication rate were compared between the two groups.Results The ureteroscope insertion time,operation time,and hospital stay in the study group were shorter than those in the control group(P<0.05),the pain score 1 day after surgery was lower(P<0.05),the success rate of one-time lithotripsy was higher(P<0.05),and the stone clearance rate was slightly higher,without a statistically significant differ-ence(P>0.05).BUN,Scr,CysC,CRP,IL-6,TNF-α,Cor,NE,and MDA levels in the study group were lower than those in the control group 7 days after surgery(P<0.05).On the 7th day after surgery,the sperm density and sperm motility of both groups decreased,and the sperm malformation rate increased,but the sperm density and sperm motil-ity rate in the study group were higher,and the sperm malformation rate was lower(P<0.05).The incidence of complications between the two groups was 4.26%and 10.86%,respectively,without a statistically significant difference(P>0.05).Conclusion Holmium laser lithotripsy using F6.0/7.5 ureteroscopy for male patients with lower uret-eral calculi has a good stone removal effect and can reduce renal injury,inflammation,stress reaction,and the impact on sperm quality without increasing the risk of complications,which is worthy of clinical promotion and practice.