MP44-17 ULTRASTRUCTURAL AND IMMUNO-HISTOPATHOLOGICAL EVALUATION OF INTRAVESICAL URETERS VIA ELECTRON AND LIGHT MICROSCOPY IN CHILDREN WITH VESICOURETERAL REFLUX

Abstract

You have accessJournal of UrologyPediatrics: Urinary Tract Infection & Vesicoureteral Relux1 Apr 2014MP44-17 ULTRASTRUCTURAL AND IMMUNO-HISTOPATHOLOGICAL EVALUATION OF INTRAVESICAL URETERS VIA ELECTRON AND LIGHT MICROSCOPY IN CHILDREN WITH VESICOURETERAL REFLUX Volkan Izol, Arbil Avci Acikalin, Yurdun Kuyucu, Mutlu Deger, Ibrahim Atilla Aridogan, Sait Polat, and Nihat Satar Volkan IzolVolkan Izol More articles by this author , Arbil Avci AcikalinArbil Avci Acikalin More articles by this author , Yurdun KuyucuYurdun Kuyucu More articles by this author , Mutlu DegerMutlu Deger More articles by this author , Ibrahim Atilla AridoganIbrahim Atilla Aridogan More articles by this author , Sait PolatSait Polat More articles by this author , and Nihat SatarNihat Satar More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1392AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The cytokine profiles and ultrastructural changes in the ureterovesical junctions(UVJs) of children with primary vesicoureteral reflux(VUR) were investigated using immunohistochemical methods and transmission electron microscopy(TEM). Methods Thirty-nine distal intravesical ureters were obtained from 23 children who underwent ureteroneocystostomy for primary VUR. The ureteral wall smooth muscle organization and transforming growth factor-β1(TGF-β1), vascular endothelial growth factor(VEGF) and CD34 were evaluated immunohistochemically and compared with controls in 10 age-matched autopsy specimens.The ultrastructural evaluations and morphological descriptions were performed semi-quantitatively and compared with published data. Results Six patients (26%) were male, and 17(74%) were female, with a mean age of 73.2±34.3(12-168) months. There was no correlation between VUR grade and age(p=0.39). The smooth muscle disorganization score in the intravesical ureter patient group differed significantly from the control group(p=0.01). TGF-β1 levels were significantly higher (p=0.001) and VEGF levels and microvessel densities were significantly lower in the patients with reflux compared with the control group(p<0.001 and p<0.001, respectively). The VEGF, CD34 and TGF-β1 levels did not correlate with reflux grades(p=0.84, p=0.76 and p=0.10, respectively).The urothelium, lamina propria and tunica adventitia appeared normal in the specimens for all grades of VUR using TEM.Damage was observed in the muscular layers of the UVJs, especially in grades IV and V VUR. Conclusions We demonstrated that primary refluxing ureters exhibit immuno-histopathological abnormalities compared with normal ureters irrespective of reflux grade and ultrastructural changes were especially severe in high-grade reflux.These abnormalities can hinder the normal ureteral valve mechanism and may lead to reflux due to smooth muscle dysfunction and microvascular alterations. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e449 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Volkan Izol More articles by this author Arbil Avci Acikalin More articles by this author Yurdun Kuyucu More articles by this author Mutlu Deger More articles by this author Ibrahim Atilla Aridogan More articles by this author Sait Polat More articles by this author Nihat Satar More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...