COLLAGEN STUDIES FOR PEDIATRIC URETEROPELVIC JUNCTION OBSTRUCTION

Objectives. Ureteropelvic junction (UPJ) obstruction is the most commo n form of urinary tract obstruction in pediatrics. There is controvers y regarding the need for early surgical intervention in many patients with apparent neonatal UPJ obstruction. To demonstrate the differences in type and amount of collagen in adult and pediatric UPJ obstruction , collagen studies were performed. Methods. The experimental groups ar e 9 pediatric patients with UPJ obstruction and 13 adult patients with UPJ obstruction. Six patients with normal UPJ were assigned as contro ls for each experimental group. The collagen content of UPJ was quanti tated by hydroxyproline analysis. immunohistochemical staining and Wes tern blotting for collagen types I and III were performed. Results. Th e collagen content of pediatric UPJ was significantly lower in Value t han that of adult UPJ (P <0.05). Immunohistochemical staining revealed that collagen type I was located in interfascicular space and collage n type III was located in intrafascicular space in both age groups. In Western blotting the relative intensity of collagen type III for pedi atric UPJ was weaker than that of adult groups. Conclusions. These res ults suggest that a larger series of patients should be examined to de termine whether quantitative analysis for collagen types I and III wou ld provide some kind of prognostic test for UPJ outcome in pediatric p atients. UROLOGY 52: 494-498, 1998. (C) 1998, Elsevier Science Inc. Al l rights reserved.