SOVREMENNAYA PEDIATRIYA.2016.7(79):112-115; doi 10.15574/SP.2016.79.112 

Comparative histomorphometry ureter in infants with megaureter 

Tertyshniy S. I., Spahi O. V., Kokorkin A. D.

Zaporozhye State Medical University, Ukraine

Urgency megaureter is one of the most serious defects of the urinary system. The frequency of this disease remains high and population studies of the data from 10 to 20% in the overall structure malformations of the urinary tract in children in recent years.

Objective: to study features histoarchitectonics ureter in children with megaureter.

Materials and methods observed and treated 16 children aged 3 to 12 months with megaureter II–IV degree. Clinical diagnosis of vice was carried out on the basis of standard complex urological examination. The material of the study is based on sections of the resected ureteral. The control group consisted of observations of autopsy material — sections of the ureter in children under 1 year old who died of intercurrent diseases (n=5). We studied the relation of the muscular layer and the mucous membranes, the severity of degenerative and inflammatory changes.

Results and Discussion. The characteristic structural changes and statistically significant differences that characterize the poorly expressed, moderate and severe neuromuscular dysplasia recorded in the wall of the ureter in children with megaureter. Pathological changes in the muscular layer of the ureter are inversely proportional to dystrophic and degenerative changes of the cover transitional epithelium, which together determine the motor dysfunction of the ureters, promotes the development of secondary renal disease and justifies the need for surgical correction of the defect.

Conclusion: Our study emphasizes the importance of accounting gistomorfologii indicators in predicting the outcome of surgical treatment and its timing in infants with megaureter.

Key words: histomorphometry, megaureter, children.

REFERENCES

1. Lolaeva BM. 2011.Surgery megaureter infants. Kuban Research Medical Gazette. 6(129): 94-96.

2. Suzdaltseva LV. 2013. Clinical outcomes of structural and functional changes of kidneys in children with congenital urinary tract. Herald of new medical technologies. 2: 283-288.

3. Jusko EI. 2006. Diagnosis of obstructive uropathy of the upper urinary tract in children and choice of temporary urinary diversion. Health. 6: 61-64.

4. Yurtcu M, Gurbuzer N, Findik S et al. 2009. Investigation of histopathologic changes in the ureter walls in vesicoureteral reflux. J Pediatr Surg. 44(4): 802—805. https://doi.org/10.1016/j.jpedsurg.2008.08.018; PMid:19361644

5. Arena S, Magno C, Montalto AS et al. 2012. Long-term follow-up of neonatally diagnosed primary megaureter: rate and predictors of spontaneous resolution. Scand J Urol Nephrol. 46(3): 201—207. https://doi.org/10.3109/00365599.2012.662695; PMid:22397575

6. Di Renzo D, Aguiar L, Cascini V et al. 2013. Long-term followup of primary nonrefluxing megaureter. J Urol. 190(3): 1021—1026. https://doi.org/10.1016/j.juro.2013.03.008; PMid:23500640

7. Chevalier RL, Thornhill BA, Forbes MS, Kiley SC. 2010. Mechanisms of renal injury and progression of renal disease in congenital obstructive nephropathy. Pediatr Nephrol. 25: 687—697. https://doi.org/10.1007/s00467-009-1316-5; PMid:19844747

8. Vlad M, Ionescu N, Ispas AT et al. 2007. Morphological study of congenital megaureter. Romanian Journal of Morphology and Embryology. 48(4): 381—390. PMid:18060188

9. Nagy V, Baca M, Boor A. 2013. Primary obstructed megaureter (POM) in children. Bratisl Lek Listy. 114(11): 650—656. https://doi.org/10.4149/bll_2013_139

10. Shukla AR, Cooper J, Patel RP et al. 2005. Prenatally detected primary megaureter: a role for extended follow-up. J Urol. 173(4): 1353—1356. https://doi.org/10.1097/01.ju.0000152319.72909.52; PMid:15758800

11. Castagnetti M, Novara G, Beniamin F et al. 2008. Scintigraphic renal function after unilateral pyeloplasty in children: a systematic review. BJU INT. 102: 862—868. https://doi.org/10.1111/j.1464-410X.2008.07597.x; PMid:18336599

12. Braga LH, D'Cruz J, Rickard M et al. 2016. The Fate of Primary Nonrefluxing Megaureter: A Prospective Outcome Analysis of the Rate of Urinary Tract Infections, Surgical Indications and Time to Resolution. J Urol. 195; 4; Pt 2: 1300—1305. https://doi.org/10.1016/j.juro.2015.11.049; PMid:26926548