Interstitial Cells of Cajal and their Correlation to Outcome in Congenital Urological Abnormalities.

Sir,

We read and appreciated the manuscript written by Inugala et al.[1] in the Journal of Indian Association of Pediatric Surgeons, issue of July–September 2017. In the last decade, there has been a growing interest in the involvement of interstitial cells of cajal (ICC) in urinary congenital abnormality. In this regard, ICC play a crucial role as pacemaker of the urinary tract[2] and are actually closely associated with a variety of motility disorders and many congenital urological diseases such as vesicoureteral reflux[3] and vesicoureteral junction obstruction.[4] In particular, as in ureteropelvic junction obstruction, a loss of ICC seems to correlate with severity of vesicoureteral reflux,[3] and a significant impairment of these cells was found in congenital primary obstructed megaureter, probably due to the absence of c-kit positive muscular embryological precursors.[4] In accordance with Inugala et al.[1] suggestion, we believe that it would be useful to investigate the density of ICC in the resected margin of surgical samples after ureteral reimplantation for both vesicoureteral reflux or vesicoureteral junction obstruction, to investigate if there is a correlation between ICC density and postsurgical prognosis. These studies, where appropriate, might also be useful for presurgical identification of the abnormal ureteral segment and the adequate extension of resection. Finally, we would like to congratulate the authors for their work and suggestion.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.