Histopathology in Ureteropelvic Junction Obstruction With and Without Crossing Vessels

Cancian, Madeline; Pareek, Gyan; Caldamone, Anthony A.; Aguiar, Liza; Wang, Hai; Amin, Ali

doi:10.1016/j.urology.2017.05.013

Cited by 13 publications

(12 citation statements)

References 12 publications

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“…This may explain the rarity of PUJO secondary to crossing vessels in newborns and the comparatively high incidence observed in our review of the adult population. [29] Weiss et al [30] reported the detection of crossing vessels in 166 pediatric patients; although the overall rate of crossing vessels (47%) was similar to the rate seen in our review of adult patients, the median age of patients undergoing surgery was significantly higher for patients with crossing vessels (8.2 years) than for those without (0.9 years), suggesting that crossing vessels become more clinically significant with age. [30] To our knowledge, this is the first systematic review investigating the underlying etiologies of PUJO in adults.…”

Section: Discussionsupporting

confidence: 82%

“…The majority of patients with crossing vessels had no intrinsic abnormality detected histologically, whereas 90% of those without crossing vessels had an intrinsic histological abnormality, the most common finding being chronic inflammation (40%). Conversely, in a study by Cancian et al, [29] chronic inflammation was observed in histology specimens more often in those with crossing vessels than in those with intrinsic etiologies. This may explain the rarity of PUJO secondary to crossing vessels in newborns and the comparatively high incidence observed in our review of the adult population.…”

Section: Discussionmentioning

confidence: 84%

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Pelviureteric junction obstruction in adults: A systematic review of the literature

O’Sullivan

Anderson

2022

Curr Urol

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BackgroundPelviureteric junction obstruction (PUJO) is a common urological disorder that can present at any stage of life. The underlying etiology in children has been well studied; however, a gap exists in the literature for the adult population. Herein, we performed a systematic review of the literature to evaluate the current evidence on the underlying etiologies of adult patients presenting with PUJO.Materials and methodsFour electronic databases were searched for relevant studies assessing the underlying etiologies of pelviureteric junction obstruction in adults. Studies were assessed for eligibility based on predefined inclusion and exclusion criteria, and a critical appraisal of methodological quality and risk of bias was performed. Finally, qualitative and quantitative data analyses were performed.ResultsTwelve studies comprising a total of 513 patients with radiologically confirmed PUJO met the inclusion criteria and were included in our analysis. The most common finding was crossing vessels, which were observed in 50.5% of patients, followed by intrinsic ureteral stenosis (27.1%), adhesions (15.3%), and high insertion of the ureter (10.1%).ConclusionsThe underlying etiologies of PUJO in adults remain unclear. This study indicated that obstruction secondary to crossing vessels is the most common cause of obstruction in adults and occurs more frequently than in the pediatric population.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 84%

Pelviureteric junction obstruction in adults: A systematic review of the literature

O’Sullivan

Anderson

2022

Curr Urol

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“…The etiology of the obstruction can be intrinsic, extrinsic or mixed. According to literature data, the presence of CV in patients with hydronephrosis ranges from 11 to 58% in different cohorts [20][21][22][23]. In our study, we found the presence of CVs in 25% of the children operated for hydronephrosis in a 7-year period.…”

Section: Discussionsupporting

confidence: 68%

Uretero-pelvic junction obstruction with and without crossing vessels: surgical outcome in a single center experience

et al. 2020

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Purpose Uretero-pelvic junction obstruction is the most common cause of prenatal hydronephrosis. It can be intrinsic, extrinsic due to crossing vessel (CV) or mixed. This paper aims to present the surgical outcome in a single pediatric thirdlevel center. Methods A retrospective analysis of all children operated between 2011 and 2018 was conducted. Demographic information, pre-operative pelvic antero-posterior diameter (APD), intra-operative parameters, hospital stay and follow-up were considered. Re-do operations and success rate for Vascular Hitch (VH), open and laparoscopic pyeloplasties were recorded. Results 128 patients were included. The mean pre-operative APD was 30 mm. The etiology was intrinsic in 71.9%, extrinsic in 25.0% and mixed in 3.1%. The median age between intrinsic and extrinsic groups was statistically different. Thirty-one VH, 88 dismembered and 9 non-dismembered pyeloplasties were performed. The median hospital stay was 2 days for VH and 6 for pyeloplasties. The median hospital stay was statistically longer in open pyeloplasties compared to laparoscopic. The mean post-operative APD was 14 mm. The success rate after VH was 90.3%, after open pyeloplasties 97.9% and after mini-invasive pyeloplasties 91.8%. Conclusions VH could be a good option in the treatment of hydronephrosis due to CV, laparoscopic pyeloplasties have equivalent success rate and shorter hospital stay than open pyeloplasties.

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“…12) or posteriorly over the ureter. Lower pole crossing vessels are found in about 20% of healthy patients, while their incidence is up to 45% in patients with UPJO [35].…”

Section: Ureteropelvic Junction Obstructionmentioning

confidence: 99%

CT imaging findings of abdominopelvic vascular compression syndromes: what the radiologist needs to know

et al. 2020

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Abdominopelvic vascular compression syndromes include a variety of uncommon conditions characterized by either extrinsic compression of blood vessels by adjacent anatomical structures (i.e., median arcuate ligament syndrome, nutcracker syndrome, May-Thurner syndrome) or compression of hollow viscera by adjacent vessels (i.e., superior mesenteric artery syndrome, ureteropelvic junction obstruction, ureteral vascular compression syndromes, portal biliopathy). These syndromes can be unexpectedly diagnosed even in asymptomatic patients and the predisposing anatomic conditions can be incidentally discovered on imaging examinations performed for other indications, or they can manifest with atypical abdominal symptoms and acute complications, which may lead to significant morbidity if unrecognized. Although computed tomography (CT) is an accurate noninvasive technique for their detection, the diagnosis remains challenging due to the uncommon clinical presentation and often overlooked imaging features. Dynamic imaging may be performed in order to evaluate patients with inconstant symptoms manifesting in a specific position. The purposes of this paper are to review the CT imaging findings of abdominopelvic vascular compression syndromes, correlating with anatomical variants and to provide key features for the noninvasive imaging diagnosis.

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Histopathology in Ureteropelvic Junction Obstruction With and Without Crossing Vessels

Cited by 13 publications

References 12 publications

Pelviureteric junction obstruction in adults: A systematic review of the literature

Pelviureteric junction obstruction in adults: A systematic review of the literature

Uretero-pelvic junction obstruction with and without crossing vessels: surgical outcome in a single center experience

CT imaging findings of abdominopelvic vascular compression syndromes: what the radiologist needs to know

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