Category: Basic Science: Stones

MP2-11 - Correlation of the expression of COX-2 and TNF-α mRNA to severity of ureteral wall lesions

Thu, Sep 20
4:00 PM - 6:00 PM

Introduction & Objective : Pro-inflammatory mediators cyclooxygenase-2 (COX-2) and tumour necrosis factor-α (TNF-α) have been shown to be significantly upregulated in ureteral wall tissue after retrograde intrarenal  surgery (RIRS) using ureteral access sheaths (UAS). The objective was to examine if upregulation of COX-2 and TNF-α mRNA during usage of UAS is affected by the occurrence or severity of ureteral wall lesions.


Methods : UAS sized 13/15 Fr. were inserted bilaterally in the ureters of laboratory pigs (55kg). After removal, 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 the Post-Ureteroscopic-Lesion-Scale (PULS). Tissue samples adjacent to lesion sites were snap frozen for q-PCR analysis of COX-2 and TNF-α mRNA.


Results : 86 observed histopathological lesions paired with adjacent COX-2 and TNF-α analysed tissue were divided into three groups: no lesion, superficial lesion (grade 1) and severe lesion (grade 2 or worse). In 9 cases there were no lesions, in 62 cases there were superficial lesions and in 15 cases there were severe lesions (grade 2 or worse). There was a trend toward higher COX-2 mRNA expression levels with higher PULS lesion severity (p=0.10; Pearsons Chi-squared median test). Regarding TNF-α there was no correlation between expression and PULS grade (p=0.66; Pearsons Chi-squared median test).


Conclusions : The up-regulation of COX-2 and TNF-α mRNA was not significantly affected by occurrence or severity of ureteral wall lesions.

Soeren K. Lildal

Dr.
Aarhus University Hospital, Skejby
Aarhus, Midtjylland, Denmark

Søren Kissow Lildal, MD, currently resident in urology at Aarhus University Hospital, Skejby, Denmark. Finished PhD Thesis "Ureteral Damage due to Acces Sheath Usage in Ureterorenoscopy" in January 2018 out of the Urological Research Department of Hospital Lillebaelt, Denmark.

Flemming B. Soerensen

Professor, Pathologist
Aarhus University Hospital, Skejby
Aarhus, Midtjylland, Denmark

Kim H. Andreassen

Urologist
Gentofte Hospital
Copenhagen, Hovedstaden, Denmark

Helene U. Jung

Urologist
Lillebaelt Hospital, Urology, Vejle, Denmark
Vejle, Syddanmark, Denmark

Malene R V.. Pedersen

Phd student
Lillebaelt Hospital, Vejle
Vejle, Syddanmark, Denmark

Palle J S. Osther

Professor of Clinical Urology
Lillebaelt Hospital, Urology, Vejle, Denmark
Vejle, Syddanmark, Denmark

Prof. Osther attended University Southern Denmark where he received his medical approval and M.D. in 1984. He was consultant urological surgeon at Odense University Hospital from 2000-2002; and at Lillebaelt Hospital from 2002 to 2004, when he became chair of the department. He received the Ph.D. degree for scientific work on pathophysiology of calcium nephrolithiasis in 1995.

Prof. Osther is currently Professor and consultant urological surgeon at Department of Urology and Director of Urological Research Center at Lillebaelt Hospital, University of Southern Denmark, Vejle, Denmark. His research interests focus on urolithiasis, upper urinary tract urothelial carcinoma, urinary tract pain, uroradiology, erectile dysfunction and prostate cancer. In his clinical practice he mainly deals with urinary stone disease and other upper urinary tract pathologies. In his areas of interest he has published extensively, and he has had numerous scientific presentations worldwide. He has been invited as guest surgeon for live surgery at several international urological meetings. During 15 years he was chairman of the Scandinavian Cooperative Group for Urinary Stones and he took the initiative to the Scandinavian Course on Urinary Stone Disease. In the period 2009-2013 he was Chairman of the EAU Section of Urolithiasis (EULIS), and he was president of the 2nd Meeting of EULIS in Copenhagen 2013. He has received several scientific awards, and he is and has been advisor for several Ph.D. students.

Prof. Osther is an honorary member of EAU Section of Urolithiasis (EULIS) and has been involved as reviewer in European Guidelines on Urolithiasis. He has been board member of the EAU Section Office, member of the Scientific Committees of Challenges in Endourology and Experts In Stone Disease. He chaired a sub-committee of the latest International Consultation on Stone Disease. Prof. Osther is member of the Editorial Board of several peer-reviewed journals.