Pelviureteric junction obstruction: how much is the extent of the upper ureter with defective innervation needing resection?

Harish, J; Joshi, Kusum; Rao, K. L. N.; Narasimhan, K. L.; Samujh, Ram; Choudhary, Siddharth; Mahajan, Jai Kumar

doi:10.1016/s0022-3468(03)00266-5

Cited by 15 publications

(11 citation statements)

References 14 publications

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“…In IUPJO, differing findings of histopathologic changes have been described: increased intermuscular and intramuscular connective tissue, or increased collagen that acts as an inelastic collar hampering ureteral peristalsis [1,6]. Alterations of innervation [20,21], muscular hypotrophy [2,3], or hypertrophy have also been reported [4] as causative or resulting alterations of the ureteral wall. Surprisingly, in our reviewed CV specimens, we did not find any lower scores for the so-called intrinsic alterations such as muscular hypertrophy, fibrosis, and chronic inflammation.…”

Section: Discussionmentioning

confidence: 99%

Differences between intrinsic and extrinsic ureteropelvic junction obstruction related to crossing vessels: histology and functional analyses

Ellerkamp¹,

Kurth²,

Schmid³

et al. 2015

World J Urol

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Section: Discussionmentioning

confidence: 99%

Differences between intrinsic and extrinsic ureteropelvic junction obstruction related to crossing vessels: histology and functional analyses

Ellerkamp¹,

Kurth²,

Schmid³

et al. 2015

World J Urol

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“…Previous investigations have implicated anomalies of the structure and ultrastructure of the UPJ. The abnormalities described include hypotrophy/hypertrophy of the smooth muscle (SM) in the obstructive segment and its replacement with excessive collagen, combined with diminution of nerve terminals and nerves at the stenotic portion [2,3]. From these observations, it has been concluded that the disruption of the coordinated motion of smooth muscle cells (SMCs) may result in an impeded transport of urine and blockage of the downward transmission of ureteral peristalsis [4].…”

mentioning

confidence: 99%

Structural changes of smooth muscle in congenital ureteropelvic junction obstruction

Hoşgör¹,

Karaca²,

Ulukuş³

et al. 2005

Journal of Pediatric Surgery

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“…Существующий стереотип хирургической тактики достаточно жёстко ассоциирован с расчленяющей пиелопластикой, при которой отсечение мочеточника выполняют, прежде чем возникает возможность оценить истинную протяжённость обструкции. Несоответствие протяжённости обструкции, определяемой в процессе продольной уретеротомии, и длины сужения, определяемого на основании внешнего осмотра [4], позволяет хирургу надеяться на возможность формирования прямого пиелоуретерального анастомоза и выполнять отсечение мочеточника на начальных этапах пиелопластики.…”

Section: The Results Of Dismembered Flap Pyeloplasty For Hydronephrosunclassified

The results of dismembered flap pyeloplasty for hydronephrosis in children

Сизонов

Коган

2012

Kazan Med J

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Aim. To evaluate the effectiveness of dismembered flap pyeloplasty for extensive obstruction of the pyeloureteral segment in children. Methods. Dismembered flap pyeloplasty throughout the period 2001-2010 was performed in 9 children (first group), mean age 69 months, 7 (77.8%) boys and 2 (22.2%) girls. Left-sided hydronephrosis was diagnosed in 8 (88.9%) cases, right-sided hydronephrosis - in 1 (11.1%) case. Dismembered flap pyeloplasty was performed in those cases, when after the resection of the ureter and during an attempt to form a direct uretero-pyelo-anastomosis excessive tension of the tissues occurred. In order to replace the resected part of the ureter used was a tubularized U-shaped flap of the renal pelvis, which was anastomosed in an «end to end» fashion with the proximal section of the ureter. The comparison group (second group, 58 patients) included patients who had undergone dismembered pyeloplasty with the formation of uretero-pyelo-anastomosis in the horizontal plane after standard resection of the dysplastic area of the proximal ureter. Results. In the early postoperative period, clinical manifestations of urinary tract infections were recorded in 1 (11.1%) of 9 patients, treated medically. The degree and rate of reduction of the increased anteroposterior size of the renal pelvis after dismembered flap pyeloplasty significantly lagged behind the comparable parameters of patients undergoing standard dismembered pyeloplasty, and at the same time, one year after the operation noted was a marked decrease in the anteroposterior size of the renal pelvis by almost 3 times as compared to the preoperative values. Conclusion. Implementation of dismembered flap pyeloplasty for extensive ureter obstruction makes it possible to achieve good short- and long-term results in the treatment of hydronephrosis in children.

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Pelviureteric junction obstruction: how much is the extent of the upper ureter with defective innervation needing resection?

Cited by 15 publications

References 14 publications

Differences between intrinsic and extrinsic ureteropelvic junction obstruction related to crossing vessels: histology and functional analyses

Differences between intrinsic and extrinsic ureteropelvic junction obstruction related to crossing vessels: histology and functional analyses

Structural changes of smooth muscle in congenital ureteropelvic junction obstruction

The results of dismembered flap pyeloplasty for hydronephrosis in children

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