Abstract :
Introduction and Objectives: Most common cause for pelviuretericjunction (PUJ) obstruction is thought
to be intrinsic defect of muscular development or the deficient nerves in the obstructed narrow segment.
Other causes include obstruction from outside: crossing vessel (CV), tumor compressing PUJ etc and
intramural causes. Congenital Hydronephrosis is associated with crossing vessels in 26% of cases. The
purpose of this work is to evaluate histopathological changes in patients of PUJ obstruction with or without
crossing vessels.
Materials and Methods: This was a prospective study conducted on 128 patients who underwent
pyeloplasty from January 2016 to June 2018. Of these 42 patients had associated crossing vessels.
Hisopathological analysis of PUJ segment was done to look for chronic inflammation, muscular
hypertrophy, fibrosis, muscle disarray and synaptophysin.
Results: Moderate to severe chronic inflammation was seen in 23.8% and 44.2% (P > 0.05) cases with CV
and without CV respectively, similarly fibrosis and muscular hypertrophy was seen higher in cases without
CV although these were not statistical significant. On contrary muscle disarray shows trend of higher in
cases with CV but it was also not statistical significant. Synaptophysin was positive in 4.8% cases with CV
and 4.7% cases without CV.
Conclusion: Based on this study there is no significant statistical difference in the histopathological
changes in patients with or without crossing vessels. So crossing vessel is not the cause but an associated
finding in pelvi-ureteric junction obstruction.
Keyword :
Histopathological, PUJ synaptophysin