Histomorphological changes in the wall of the pyeloureteral segment in young children

Аннотация

Purpose of the study. To study histo- CITATION morphological changes in the wall of the pyeloureteral segment in infants early age. A.A. Nasirov. (2025). Histomorphological changes in the wall of the pyeloureteral segment in young children. The American Journal of Medical Materials and Methods. The data of the results of Sciences and Pharmaceutical Research, 7(04), 51–55. comprehensive examination and surgical treatment of https://doi.org/10.37547/tajmspr/Volume07Issue04-09 children aged from 1 month to 3 years who were treated in the urology department of the clinic of the Tashkent Pediatric Medical Institute (Tashkent Pediatric Medical COPYRIGHT Institute) and in the Training and Methodological Centre © 2025 Original content from this work may be used under the terms of Neonatal Surgery at the Republican Perinatal Centre of the creative commons attributes 4.0 License. (RPC) from 2014 to 2022 served as the material for the study. A retrospective and prospective analysis of clinical materials concerning the diagnosis and treatment of 131 children was performed. Among the patients, right-sided hydronephrosis was detected in 49 (37.4%) patients, left-sided obstruction in 73(55.7%) children, and 9 (6.9%) cases had bilateral lesions. Results. When analysing the characteristics of ureteral structural changes in age groups, it was found that in the group of children older than 1 year of age, the number of reversible and irreversible structural abnormalities did not differ significantly. In the age group of children under 1 year of age, the differences in the frequency of reversible and irreversible ureteral structural changes were statistically significant. Keywords: Hydronephrosis, children, pyeloureteral segment. Introduction: Malformations of the genitourinary organs account for 15-45% of all ano- genital malformations of embryonic development. In this case, hydronephrosis due to obstruction of the pyeloureteral segment (PUS) obstruction is the most frequent cause of plastic surgery on the upper urinary tract in children. The American Journal of Medical Sciences and Pharmaceutical Research 51 https://www.theamericanjournals.com/index.php/tajmspr The American Journal of Medical Sciences and Pharmaceutical Research According to the literature, the prevalence of PUS ultrasonography, excretory urography, micturition obstruction ranges from 2-6 cases per 1000 newborns cystography, multispiral computed tomography, and [1,2,14,18]. According to retrospective studies, clinical and laboratory investigations. antenatal detection of upper urinary tract dilatation is For radioisotope renoscintigraphy, children were 1:500, but the actual number of surgeries for PUS referred to the nuclear medicine department of the obstruction remains relatively at the level of 1:1250- Republican Specialised Nuclear Medicine Department of 1500 live births [8,16,17]. Analysis of the data on the Republican Specialised Scientific and Practical morphological abnormalities in the PUS area in Medical Centre of Endocrinology. hydronephrosis shows that dysplastic changes in the Due to the routine use of ultrasound screening of smooth muscle structures of the ureter wall, excessive pregnant women, 71 (54%) fetuses had renal cavity collagen accumulation in the intermuscular spaces, dilation detected antenatally at 26 to 32 weeks depletion of innervation in the PUS area, increased gestational age. leiomyocyte apoptosis, impaired differentiation of the uroepithelium, and various changes in the extracellular All patients underwent a comprehensive examination, matrix are accurately established. However, to date, which included clinical and laboratory diagnostic there is no consensus on the etiology and pathogenesis methods, radiology, and radiotherapy, laboratory of morphological changes in the PUS [14,16,17]. In the diagnostic methods, radiation, radioisotope, available literature, there are few studies on the morphological and histological methods of normal morphological picture of the pelvis and ureteric investigation. duct in children under one year of age [4,12,14] and in In determining the severity of obstruction of the pyelo- adults (over 18 years of age) [3,7,15]. urethral segment (PUS), we used the classification However, the results of most studies do not proposed by the Society for Foetal Urology, according to characterise in detail the structural changes at the which five degrees of congenital hydronephrosis are early stages of postnatal ontogenesis and are mainly distinguished. In this case, the 0 degree - unchanged devoted to, predicting the results of plastic surgeries collecting system of the kidney, the 1 degree - moderate for obstruction of the pyelo-ureteral segment enlargement of the central renal complex, the 2 degree [9,10,11,18]. Thus, the lack of unified criteria for the - enlargement of the lobule without calicoectasia, the 3 indication for one or another type of treatment of degree - enlargement of the whole PUS without congeni