Stephens F D
Trans Am Assoc Genitourin Surg. 1978;70:47-51.
Two ureteral sheaths and the vesical musculature combine to form a watertight ureterovesical junction but the precise anatomy and function of each component are still somewhat contentious. The morphology was studied in postmortem specimens of children with and without paraureteral diverticula and urethral obstruction, and function by deductive reasoning from radiographic and surgical observations in living children. Waldeyer's fascia (the superficial sheath) of the ureter was found to seal the potential space between the tunnel wall and the ureter, and deficiencies were associated with hiatal hernias. The deep sheath provided anchorage of the ureter to the trigone and through the attachments of the superficial sheath to the bladder wall. Both sheaths and the tunnel muscles could be identified clearly and dissected precisely at operations involving the ureterovesical junction to facilitate the surgical procedures.
两个输尿管鞘与膀胱肌肉组织共同构成一个防水的输尿管膀胱连接部，但各组成部分的确切解剖结构和功能仍存在一定争议。对有和没有输尿管旁憩室及尿道梗阻的儿童尸体标本进行了形态学研究，并通过对活体儿童的影像学和手术观察进行演绎推理来研究其功能。发现输尿管的瓦尔代尔筋膜（浅表鞘）封闭了隧道壁与输尿管之间的潜在间隙，其缺损与食管裂孔疝有关。深层鞘将输尿管固定于膀胱三角，并通过浅表鞘与膀胱壁的附着实现固定。在涉及输尿管膀胱连接部的手术中，可以清晰地识别并精确解剖这两个鞘和隧道肌肉，以利于手术操作。
