Structural changes of dilated pelvic ureters in adults

Abstract

PURPOSE:To perform a quantitative assessment of different types of pelvic ureter tissues with chronic dilation in adults, using stereological methods. METHODS:We analyzed fragments of dilated pelvic ureters obtained from 6 patients aged between 35 and 67 years (mean, 46 years) who underwent ureteral reimplantation surgery for different reasons. The obstruction duration ranged from 27 to 180 days (mean, 93 days). The control group included fragments of normal pelvic ureters obtained during nephrectomy in 7 kidney transplant donors (age: range, 25-51 years; mean, 36 years). The volumetric density of collagen in the ureter, elastic fibers, and smooth muscle fibers was assessed. RESULTS:The volumetric density (Vv) of collagen showed no significant difference between the two groups (control: 45.3 ± 6.1; dilated: 40.8 ± 6.9; P = 0.23). A statistically significant increase in Vv of elastic fibers was observed in the dilated ureters (control: 18.4 ± 1.2; dilated: 24.6 ± 5.4; P = 0.03). A statistically significant increase in the Vv of smooth muscle fibers was observed in the dilated ureter (control: 42.0 ± 6.0; dilated: 56.2 ± 6.1; P = 0.001). CONCLUSION:The chronically dilated pelvic ureters had significantly more elastin and smooth muscle contents than the controls.

Pathogenic Mechanisms of Acute Obstructive Pyelonephritis

“…Dynamic obstruction is generated by such reasons as dysfunction of the bladder`s muscular tissue (neurosystemic dysplasia), urinary reflux caused by pathology of the prostate, doubling of the ureters, and ureterocele. These factors are favorable basis for persistence and recurrence of infection and they lead to acute purulent kidney damage [15], [16].…”

“…Therefore, the location of obstruction's factor has a significant effect on the development of the inflammatory process in the kidneys. Consequently, conditions such as a high risk of pyelorenal, pyelovenous, and pyelolymphatic reflux can develop, which can trigger systemic inflammatory processes and sepsis [16].…”

Πειραματική Μελέτη Και Προσομοίωση Της Μηχανικής Συμπεριφοράς Ιστών Του Ανθρώπειου Ουροποιητικού Συστήματος

“…Πειραματική μελέτη και προσομοίωση της μηχανικής συμπεριφοράς ιστών του ανθρωπείου ουροποιητικού συστήματος -11 - [20], [21], τον Pagano και συνεργάτες [38], τον Lee και συνεργάτες [30] και πιο πρόσφατα από τον Neves [36]. Μια σημαντική μελέτη έγινε από τον Knudsen και συνεργάτες [29]…”