Morphological changes of the bladder wall of fetuses with antenatally detected syndrome "megacystis"

Objective: To determine the morphological features of the structure of the wall of the urinary bladder of the fetus with antenatally identified syndrome "megacystis". Material and Methods: Morphological investigations of the bladder wall of 11 fetuses of 12-21 weeks of gestation with diagnosed "megacystis" syndrome, obtained as a result of the termination of pregnancies, were carried out. The study was carried out using survey method, histochemical and immunohistochemical staining methods. Results: In all cases, the structure of the bladder wall with diagnosed syndrome "megacystis" sharply differed from the norm. The changes affected all layers, but the most pronounced pathological processes developed in the muscle layer, which did not differentiate into layers, the process was accompanied by a violation of the course of muscle fibers. Detrusor hypotrophy was observed in fetuses up to 18 weeks of gestation, the thickness of which decreased on average by 1,8 times. In fetuses with a gestational age of 21 weeks, the hypertrophic variant of the detrusor prevailed with an increase in its thickness by 2,6 times. In all cases, there was a significant depletion of the muscle wall with blood vessels up to 6% of the norm and a decrease in the number of nerve fibers to 24%. Conclusion. The study allowed to distinguish two variants of changes in the bladder at the syndrome "megacystis": "hypertrophic variant", characterized by an increase in the thickness of the muscle layer, and "hypotrophic variant", characterized by a decrease in the thickness of the muscle layer, which fits into the diagnostic concept of "detrusor dysplasia".