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Outcomes of ureteroscopy miniaturization on tissue damage and tissue hypoxia in a pig model

Juan P Caballero-Romeu1, Juan A Galán-Llopis2, Federico Soria3

  • 1Urology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain. juanpablocaballero@gmail.com.

Scientific Reports
|January 12, 2018
PubMed

Insights

Micro-ureteroscopy (m-URS) causes less ureteral orifice and epithelial damage than conventional ureteroscopy (URS). Both techniques, however, induce cellular hypoxia in the urinary tract.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Histopathology

Background:

  • Miniaturization of ureteroscopy (URS) aims to reduce tissue trauma.
  • The impact of micro-ureteroscopy (m-URS) on tissue hypoxia and damage requires thorough evaluation.
  • Previous studies have not adequately assessed the gross and microscopic effects of m-URS versus conventional URS.

Purpose of the Study:

  • To compare the gross and microscopic tissue damage caused by m-URS and conventional URS.
  • To assess the incidence of tissue hypoxia associated with both ureteroscopy techniques.

Main Methods:

  • A comparative study was conducted on 14 pigs.
  • Conventional URS (8/9.8 F) was performed on one ureter, and m-URS (4.85 F sheath) on the contralateral ureter.
  • Gross assessment of ureteral wall and orifice damage, hematoxylin-eosin staining, and pimonidazole staining for hypoxia were utilized.

Main Results:

  • Conventional URS showed significant ureteral wall damage, while m-URS did not.
  • Microscopic analysis revealed greater epithelial desquamation with conventional URS compared to m-URS.
  • Pimonidazole staining indicated significant hypoxia in epithelial cells for both URS and m-URS.

Conclusions:

  • Micro-ureteroscopy results in less damage to the ureteral orifice and epithelium than conventional ureteroscopy.
  • Histopathological findings support the reduced tissue trauma associated with m-URS.
  • Both conventional URS and m-URS are associated with cellular hypoxia.

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