Mp04-04 the Mechanism of Ureteral Strictures Caused by Ureteroscopic Lithotripsy: A Pathological Insight

You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) I (MP04)1 May 2024MP04-04 THE MECHANISM OF URETERAL STRICTURES CAUSED BY URETEROSCOPIC LITHOTRIPSY: A PATHOLOGICAL INSIGHT Kengo Kawase, Shuzo Hamamoto, Kazumi Taguchi, Koei Torii, Masahiko Isogai, Takeru Sugino, Rei Unno, Atsushi Okada, and Takahiro Yasui Kengo KawaseKengo Kawase , Shuzo HamamotoShuzo Hamamoto , Kazumi TaguchiKazumi Taguchi , Koei ToriiKoei Torii , Masahiko IsogaiMasahiko Isogai , Takeru SuginoTakeru Sugino , Rei UnnoRei Unno , Atsushi OkadaAtsushi Okada , and Takahiro YasuiTakahiro Yasui View All Author Informationhttps://doi.org/10.1097/01.JU.0001008708.00982.a9.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteral stricture (US) is a serious complication following ureteroscopic lithotripsy (URSL). US can lead to pain and decreased kidney function, necessitating ureteral incision or ureteroplasty. Ureteral strictures are thought to be caused by physical and thermal injuries from access sheaths and lasers; however, the exact cause remains unclear. In this study, we pathologically examined the tissues from patients who developed US following URSL. METHODS: We conducted a retrospective analysis of patients at Nagoya City University. Pathological specimens from 13 patients who underwent robot-assisted ureteroplasty for US after URSL, and 3 who had robot-assisted pyeloplasty, were reviewed. The procedures spanned from April 2023 to August 2023. All extracted specimens were subjected to pathological examination. Histopathological analysis was evaluated by hematoxylin and eosin staining, Masson's trichrome staining to determine tissue levels of fibrosis and Pizzolato staining and polarized light microscope to observe the calcification in the US site. RESULTS: The cohort consisted of four females, with an average age of 50.9±9.7 years. The preoperative hydronephrosis grades were 2 in one case, 3 in three cases, and 4 in nine cases. The ureteral strictures were located at the renal pelvic–ureter junction in three cases, U1 in six, U2 in two, and U3 in one. Pathological findings of US tissues after URSL revealed loss of ureteral mucosa (Figure 1A) in four cases, inflammatory cell infiltration (Figure 1B, C) in eleven, fibrosis of periureteral tissues (Figure 1D) in eleven, microcalcifications (Figure 1E, F) in seven. CONCLUSIONS: The pathological findings suggest that the loss of urothelial mucosa, presence of inflammation and fibrosis, and the invasion of micro stones into the damaged regions are contributing factors to the development of refractory ureteral strictures. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e33 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kengo Kawase More articles by this author Shuzo Hamamoto More articles by this author Kazumi Taguchi More articles by this author Koei Torii More articles by this author Masahiko Isogai More articles by this author Takeru Sugino More articles by this author Rei Unno More articles by this author Atsushi Okada More articles by this author Takahiro Yasui More articles by this author Expand All Advertisement PDF downloadLoading ...