Etio-pathogenic and morphological correlations in congenital hydronephrosis

Vol. 52 No. 1 Suppl., 2011
This supplement was not sponsored by Outside Organizations.


Madalina Bosoteanu, C. Bosoteanu, Mariana Deacu, Mariana Aschie, P. Bordei

Hydronephrosis, "distension in varying degrees of pelvis and calyces, accompanied by progressive atrophy of renal parenchyma due to obstruction in urinary flow", is an apparently simple reno-urinary disease, but, in reality, by association of its own characters with those conferred by causative lesions, becomes of a significant complexity. The purpose of this paper is to demonstrate the plurivalent character of this entity on a batch of cases with congenital hydronephrosis, by identification of lesional features correlated with cause of disease. The etiology of hydronephrosis in analyzed cases was characterized by heterogeneity: polar inferior artery, horseshoe kidney, extrarenal pelvis, transverse valves of pelviureteral junction (PUJ), adhesion of ureter to PUJ, intrinsic stenosis of PUJ, vesico-ureteral reflux, posterior urethral valves, stenosis of urethral meatus. The way of intervention of urinary obstruction and the uni- or bilateral character of damage were definitory for the macroscopical appearance of the hydronephrotic kidney, renal pelvis demonstrating its role of expansion room for kidney protection. In analyzed cases of congenital hydronephrosis, correlation specific cause-pelvic lesion evidenced histopathological differences related to etiology. Anatomical preparations obtained by injection followed by corrosion have revealed that renal vessels appear elongated, distanced from each other and even reduced in density, which explains the appearance of ischemia accompanying pathogenetic changes of obstructive uropathy. Regardless of etiology, all cases of congenital hydronephrosis were characterized by varying degrees of fibrosis in chorion of renal pelvis, accompanied by active chronic inflammation, observation that support the idea of connection between the two pathological changes.

Corresponding author: Madalina Bosoteanu, Lecturer, MD, PhD, e-mail:

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Andrada Loghin, O. Preda, V. Bacarea, C. Moldovan, D. Porav-Hodade, Alis Dema, Nicole Berger, Angela Borda

Prostate cancer (PCa) is the second most frequent malignant tumor in men worldwide and the most common form of cancer in men over 50-year-old. The adequate preoperative estimation of tumor volume in order to identify small tumors that lack a short-term aggressive behavior and do not necessitate a forthwith-radical prostatectomy (RP) is the subject of various recent studies and numerous debates. In this study, that included 128 cases, we attempted to evaluate some of the common preoperative variables (patient's age, total prostate volume determined on ultrasound examination, serum PSA, the number of positive biopsies and tumor size, the percentage of tumor length and the Gleason score) that could predict the tumor volume on the final RP. Based on these correlations, we develop a scoring system that combines only the Gleason score, the number of positive biopsies and the percentage of tumor length and that has been statistically proved to be correlated and predictive for the tumor volume. Our study brings additional and practical information about a true and effective prospective evaluation of the volume of the PCa.

Corresponding author: Andrada Loghin, MD, PhD, e-mail:

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