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  3. Vol. 16 No. 3 (2019): May-June 2019
  4. ORIGINAL PAPER (PEDIATRIC UROLOGY)

Vol. 16 No. 3 (2019)

June 2019

Evaluation of the Intravesical Ureters after Failed Endoscopic Treatment of Vesicoureteral Reflux with Dextranomer/hyaluronic Acid in Children via Light and Transmission Electron Microscopic Analysis. A Matched Case-Control Study

  • Volkan Izol
  • Yurdun Kuyucu
  • Arbil Acikalin
  • Mutlu Deger
  • Ibrahim Atilla Aridogan
  • Sait Polat
  • Nihat Satar

Urology Journal, Vol. 16 No. 3 (2019), 17 June 2019 , Page 279-284
https://doi.org/10.22037/uj.v16i3.4281 Published: 2019-06-17

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Abstract

Introduction: The cytokine profile and the ultrastructural changes of refluxing ureterovesical junctions(UVJs) of children treated with failed dextranomer/hyaluronic-acid (Dx/HA) injections were investigated using immunohis­tochemical methods and transmission electron microscopy(TEM).

Patients and Methods: Eighteen children who had undergone injection for reflux were included the study. The smooth muscle arrangement of the ureteral wall, transforming growth factor-? (TGF-?1),vascular-endotheli­al-growth factor (VEGF) and CD34 were evaluated immunohistochemically, and the results were compared with 10 age-matched autopsy specimens as controls. The ultrastructural evaluation and morphological description was made semi-quantitatively and compared with published data.

Result: Four of the patients (22%) were male, and 14 (78%) were female. The mean age of the patients was 105.4 ± 44.5(48-184) months. There was no correlation between the vesicoureteral reflux (VUR) grade and age (P = 0.85). The mean VEGF and CD34 scores were 16.2 ± 9.6 (0-90) cells per HPF and 10.2 ± 3.5 (4-16) vessels per HPF in ureters with reflux; these values were 60.6±16.4 (32-84) cells per HPF and 17.8 ± 4.1 (12-24) vessels per HPF in the control group. The amount of VEGF and CD34 were significantly decreased in patients compared with the control group (P < 0.001, P < 0.001).The TGF-?1 levels were significantly higher in patients with VUR compared with the control group (34.2 ± 19.9 vs 5.0±1.9; P=0.001).The amount of VEGF, CD34, and TGF-?1 were not correlated with the grade of reflux (P = 0.26, P = 0.94, and P = 0.42, respectively). Ultrastructural changes in the muscle cells were observed in all the VUR specimens (Grade II-IV).

Conclusion: Refluxing ureters exhibited immune-histopathological abnormalities and ultrastructural changes of the muscle cells in all VUR specimens in the ureterovesical junctions of children treated with failed Dx/HA injec­tions for reflux.

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How to Cite

Izol, V., Kuyucu, Y., Acikalin, A., Deger, M., Aridogan, I. A., Polat, S., & Satar, N. (2019). Evaluation of the Intravesical Ureters after Failed Endoscopic Treatment of Vesicoureteral Reflux with Dextranomer/hyaluronic Acid in Children via Light and Transmission Electron Microscopic Analysis. A Matched Case-Control Study. Urology Journal, 16(3), 279–284. https://doi.org/10.22037/uj.v16i3.4281
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