PATHOMORPHOLOGICAL ASPECTS OF URETHRAL STRICTURES OF VARIOUS ETIOLOGIES


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Abstract

Introduction. The study of the structure of strictures of various etiologies is an open and uncertain issue of modern urology. Aim. To evaluate the morphological and immunohistochemical structure of strictures of various etiologies. Materials and methods. The study involved postoperative tissue of a pathologically altered urethra of 110 patients aged 23 to 74 years who underwent treatment at the University Clinic of Urology, Russian National Research Medical University. N.I. Pirogova (2014-2018) with Ds: urethral stricture. Morphological study: Van-Gieson staining; hemotoxylin - eosin. Immunohistochemical study: mouse monoclonal antibodies to muscle and connective tissue markers (Smooth Muscle Actin, Vimentin, Calponin) and inflammation markers (CD45R, CD58, CD138, CD20, CD3) were used as primary antibodies in all reactions. Results. According to the revealed morphological changes, the material was divided into three groups: group I (n=27) - active inflammation; group II (n=33) - the predominant development of connective tissue with low activity of inflammation; group III (n=50) - mixed (chronic mild inflammation, an even amount of connective tissue). In a morphological study of idiopathic urethral strictures, it was noted that the multicolumnar epithelium was replaced by a multi-layer flat epithelium with a weakly pronounced keratinization. Inflammatory changes were mild, including the submucosal connective tissue and the spongy body. Spongiofibrosis is accompanied by a significant reduction in the vascular bed of both venous sinuses and arteries. The same changes were observed in the inflammatory genesis of urethral strictures. In the study of strictures with traumatic etiology, a restructuring of the cylindrical epithelium was observed. In cases with severe inflammation in the mucosa, the changes were atrophic-hyperplastic in nature with reactive cell atypia. Conclusion: urethral Strictures in men have a specific etiological factor, but the pathogenesis of urethral lesions can be divided into: post-traumatic and post-inflammatory.

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About the authors

S. V Kotov

Pirogov Russian National Research Medical University; N.I. Pirogov Medical State City Hospital № 1

Email: urokotov@mail.ru
Doctor of Medical Sciences, Head of the department of Urology, Pirogov Russian National Research Medical University Moscow, Russia

A. P Raksha

N.I. Pirogov Medical State City Hospital № 1; Pirogov Russian National Research Medical University

D.Med.Sci., Professor, Head of the Department of Pathology N. I. Pirogov Medical State City Hospital № 1 Moscow, Russia

R. I Guspanov

Pirogov Russian National Research Medical University; N.I. Pirogov Medical State City Hospital № 1

Email: uroguspanov@yandex.ru
PhD., associate Professor department of Urology, Pirogov Russian National Research Medical University, doctor of urology N. I. Pirogov Medical State City Hospital № 1 Moscow, Russia

M. K Semenov

Pirogov Russian National Research Medical University; N.I. Pirogov Medical State City Hospital № 1

Email: semenov_m.k@mail.ru
graduate student, department of Urology, Pirogov Russian National Research Medical University, doctor of urology N. I. Pirogov Medical State City Hospital № 1 Moscow, Russia

T. N Sotnikova

Pirogov Russian National Research Medical University

Assistant lecturer at the Department of Pathology Moscow, Russia

E. Kh Abdulkhalygov

Pirogov Russian National Research Medical University; N.I. Pirogov Medical State City Hospital № 1

Email: eldarovich.uro@mail.ru
post-graduate, department of Urology, Pirogov Russian National Research Medical University, doctor of urology N. I. Pirogov Medical State City Hospital № 1 Moscow, Russia

M. M Iritsyan

Pirogov Russian National Research Medical University; N.I. Pirogov Medical State City Hospital № 1

Email: misha-res@yandex.ru
graduate student, department of Urology, Pirogov Russian National Research Medical University, doctor of urology N. I. Pirogov Medical State City Hospital № 1 Moscow, Russia

I. I Survillo

N.I. Pirogov Medical State City Hospital № 1

Email: survillo.igor@mail.ru
urologist Moscow, Russia

References

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  2. Singh M., Blandy J.P. The pathology of urethral stricture. J Urol. 1976;115:673-676.
  3. Наранов С.В. Идиопатические стриктуры уретры у мужчин: дис.. канд. мед. наук : 14.01.23. Ростов-на-Дону, 2015. 121 с.
  4. Коган М.И., Красулин В.В., Митусов В.В., Шангичев А.В., Глухов В.П., Наранов С.В. Оперативное лечение стриктур и облитераций. Урология. 2015;2:17-23.
  5. Котов С.В., Беломытцев С.В., Гуспанов Р.И., Семенов М.К., Ирицян И.И., Угурчиев А.М. Ятрогенные стриктуры уретры у мужчин. Урология. 2018;4:56-63.

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