Hypothesis - a congenitally lax pubourethral ligament may be a contributing cause of vesicoureteral reflux.
作者信息
Gunnemann Alfons, Petros Peter
机构信息
Department of Urology, Klinikum Lippe, Detmold, Germany.
University of New South Wales, Academic Department of Surgery, St. Vincent's Clinical School, Sydney, Australia.
出版信息
Cent European J Urol. 2012;65(1):48-50. doi: 10.5173/ceju.2012.01.art16. Epub 2012 Mar 19.
INTRODUCTION
The hypothesis derives from the field of female stress incontinence. Application of pressure on the anterior vaginal wall at midurethra with a hemostat restores the geometry of the vesicoureteral junction and continence.
METHODS
We applied unilateral midurethral pressure during a radiological investigation of a 15-year-old female patient who had undergone 2 surgeries for ureteric reflux.
RESULTS
On injection of the dye into the bladder, reflux was noted in the left ureter, and this disappeared within 2-3 seconds after pressure was applied on 2 successive occasions in the midurethral area of the vagina.
CONCLUSION
The hypothesis that a musculoelastic mechanism dependent on a competent pubourethral ligament may play a role in vesicoureteral valve closure appears to have been confirmed, at least in one case. Hopefully this observation will lead to further studies, and perhaps, new directions for therapy.
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