Document Detail

Histologic differences between extrinsic and intrinsic ureteropelvic junction obstruction.
MedLine Citation:
PMID:  20394972     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Ureteropelvic junction obstruction (UPJ) can be caused by intrinsic disorganization or extrinsic compression from crossing vessels (CV). What is not clear is whether there is also intrinsic UPJ pathology in patients with CV. Recent surgeries, such as the Hellström vascular hitch procedure, move the CV cephalad without resecting the UPJ, which presumes no intrinsic narrowing. Our aim was to determine whether the histologic features of the 2 types of UPJ obstruction are distinct enough to enable a blinded pathologist to histologically identify the cause of obstruction. METHODS: We reviewed all patients undergoing pyeloplasties from 2000 to 2006. All CV cases with available pathology were selected. A random selection of intrinsic cases was used as controls. One blinded pathologist reviewed the histology, specifically scoring muscle and collagen density. RESULTS: Sixteen patients were reviewed. Seven had CV and 9 had intrinsic obstruction. Muscle density was different between the 2 groups with CV denser compared with intrinsic (P = .005). The pathologist correctly assigned the cause of obstruction in 5/7 (71%) of CV and 7/9 (78%) of intrinsic cases (P = .039). CONCLUSIONS: Identification of a significant CV intraoperatively does translate to a discernible appearance histologically.
Jenny H Yiee; Sarah Johnson-Welch; Linda A Baker; Duncan T Wilcox
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-04-14
Journal Detail:
Title:  Urology     Volume:  76     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-4     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Inc.
Department of Urology, University of Texas Southwestern Medical School, Dallas, TX, USA.
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MeSH Terms
Kidney Pelvis / pathology*
Retrospective Studies
Ureteral Obstruction / etiology,  pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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