TY - JOUR
T1 - Histopathological correlations to ureteral lesions visualized during ureteroscopy
AU - Lildal, Søren Kissow
AU - Sørensen, Flemming Brandt
AU - Andreassen, Kim Hovgaard
AU - Christiansen, Frederikke Eichner
AU - Jung, Helene
AU - Pedersen, Malene Roland
AU - Osther, Palle Jörn Sloth
PY - 2017/10/1
Y1 - 2017/10/1
N2 - PURPOSE: To correlate ureteral lesions visualized during ureteroscopy with histopathological findings.MATERIALS AND METHODS: Ureteral access sheaths (UAS) sized 13/15 Fr. were inserted bilaterally in 22 laboratory pigs. During retraction of the UAS with a semirigid ureteroscope inside, ureteral lesions were evaluated and registered using the Post-ureteroscopic lesion scale (PULS). Ureters were excised in vivo between the uretero-pelvic junction and the uretero-vesical junction. Embedded in paraffin, 4-µm thick sections were step sectioned at 250-300 µm intervals and haematoxylin and eosin (HE) stained. Histopathological scoring of ureteral wall lesions was subsequently performed according to PULS.RESULTS: In 72.1% of ureters, the highest histopathological score was at least 1 grade higher than the highest endoscopic PULS score. For 12 (27.9%) lesions, the difference was 2 scores higher, and for 1 (2.3%), it was 3 scores higher. The histopathological PULS grade was higher than the endoscopical PULS grade at all minimum, quartile, and maximum scores. There was a significant difference in the distribution of highest lesional scores between the endoscopic and histopathological PULS (p = 0.002). The calculated mean of the highest scores was 1.49 for endoscopic PULS and 2.51 for histopathological PULS (p <0.0001).CONCLUSION: Histopathological evaluation of ureteral wall lesions after UAS placement revealed a significantly higher degree of severity than observed endoscopically. Thus, endoscopy underestimated the histopathological extent of the lesion in the majority of cases.
AB - PURPOSE: To correlate ureteral lesions visualized during ureteroscopy with histopathological findings.MATERIALS AND METHODS: Ureteral access sheaths (UAS) sized 13/15 Fr. were inserted bilaterally in 22 laboratory pigs. During retraction of the UAS with a semirigid ureteroscope inside, ureteral lesions were evaluated and registered using the Post-ureteroscopic lesion scale (PULS). Ureters were excised in vivo between the uretero-pelvic junction and the uretero-vesical junction. Embedded in paraffin, 4-µm thick sections were step sectioned at 250-300 µm intervals and haematoxylin and eosin (HE) stained. Histopathological scoring of ureteral wall lesions was subsequently performed according to PULS.RESULTS: In 72.1% of ureters, the highest histopathological score was at least 1 grade higher than the highest endoscopic PULS score. For 12 (27.9%) lesions, the difference was 2 scores higher, and for 1 (2.3%), it was 3 scores higher. The histopathological PULS grade was higher than the endoscopical PULS grade at all minimum, quartile, and maximum scores. There was a significant difference in the distribution of highest lesional scores between the endoscopic and histopathological PULS (p = 0.002). The calculated mean of the highest scores was 1.49 for endoscopic PULS and 2.51 for histopathological PULS (p <0.0001).CONCLUSION: Histopathological evaluation of ureteral wall lesions after UAS placement revealed a significantly higher degree of severity than observed endoscopically. Thus, endoscopy underestimated the histopathological extent of the lesion in the majority of cases.
KW - Journal Article
UR - http://www.scopus.com/inward/record.url?scp=85017454772&partnerID=8YFLogxK
U2 - 10.1007/s00345-017-2035-3
DO - 10.1007/s00345-017-2035-3
M3 - Tidsskriftartikel
C2 - 28405762
SN - 0724-4983
VL - 35
SP - 1489
EP - 1496
JO - World Journal of Urology
JF - World Journal of Urology
IS - 10
ER -