Histopathological correlations to ureteral lesions visualized during ureteroscopy

Søren Kissow Lildal, Flemming Brandt Sørensen, Kim Hovgaard Andreassen, Frederikke Eichner Christiansen, Helene Jung, Malene Roland Pedersen, Palle Jörn Sloth Osther

Research output: Contribution to journalJournal articleResearchpeer-review

96 Downloads (Pure)

Abstract

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.

Original languageEnglish
JournalWorld Journal of Urology
Volume35
Issue number10
Pages (from-to)1489-1496
ISSN0724-4983
DOIs
Publication statusPublished - 2017

Fingerprint

Ureteroscopy
Ureter
Ureteroscopes
Hematoxylin
Eosine Yellowish-(YS)
Paraffin

Keywords

  • Journal Article

Cite this

Lildal, Søren Kissow ; Sørensen, Flemming Brandt ; Andreassen, Kim Hovgaard ; Christiansen, Frederikke Eichner ; Jung, Helene ; Pedersen, Malene Roland ; Osther, Palle Jörn Sloth. / Histopathological correlations to ureteral lesions visualized during ureteroscopy. In: World Journal of Urology. 2017 ; Vol. 35, No. 10. pp. 1489-1496.
@article{ba60932eea4a4a549fe0c943553bba7d,
title = "Histopathological correlations to ureteral lesions visualized during ureteroscopy",
abstract = "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.",
keywords = "Journal Article",
author = "Lildal, {S{\o}ren Kissow} and S{\o}rensen, {Flemming Brandt} and Andreassen, {Kim Hovgaard} and Christiansen, {Frederikke Eichner} and Helene Jung and Pedersen, {Malene Roland} and Osther, {Palle J{\"o}rn Sloth}",
year = "2017",
doi = "10.1007/s00345-017-2035-3",
language = "English",
volume = "35",
pages = "1489--1496",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Heinemann",
number = "10",

}

Histopathological correlations to ureteral lesions visualized during ureteroscopy. / Lildal, Søren Kissow; Sørensen, Flemming Brandt; Andreassen, Kim Hovgaard; Christiansen, Frederikke Eichner; Jung, Helene; Pedersen, Malene Roland; Osther, Palle Jörn Sloth.

In: World Journal of Urology, Vol. 35, No. 10, 2017, p. 1489-1496.

Research output: Contribution to journalJournal articleResearchpeer-review

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

Y1 - 2017

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

U2 - 10.1007/s00345-017-2035-3

DO - 10.1007/s00345-017-2035-3

M3 - Journal article

C2 - 28405762

VL - 35

SP - 1489

EP - 1496

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 10

ER -