Introduction. To facilitate the stage of formation of ureteropyeloanastomosis, a number of authors have recommended preliminary ureteral stent placement.
Objective. To evaluate morphological changes of the ureter that occur in response to the installation of a ureteral stent in patients with stricture of the pelvic-ureteral segment in various duration of preliminary ureteral stent placement.
Materials and methods. Histological examination of resected fragments of 73 ureters was performed in patients with congenital stenosis of the pelvic-ureteral segment after dissecting laparoscopic pyeloplasty. 3 groups were formed depending on the presence of a preoperative stent and the duration of prestenting of the ureter.
Results. In the group of patients without stenting, histological examination of the stricture zone revealed hypotrophy of the muscular membrane, with disorganization of the muscle layers, fibrosis. There is a normal morphological pattern outside the ureteral stenosis zone. In the prestenting groups, thickening of the ureteral wall was noted, mainly due to hypertrophy of the muscular layer, signs of inflammation in the form of polymorphocellular infiltration and edema of all layers of the ureter were revealed. Stenting for more than 7 days revealed signs of productive inflammation – the development of secondary fibrosis.
Conclusion. The results of the study demonstrate the possibility of considering pre-stenting as an auxiliary tool for preparing the urinary tract before laparoscopic pyeloplasty, which, due to morphological changes leading to changes in its extensibility and inhibition of peristalsis, may have a potentially beneficial effect on the results of pyeloplasty due to more optimal conditions for the fusion of the anastomosis.
