Kim Hyoung-Ho, Choi Young Ho, Lee Seung Bae, Baba Yasutaka, Kim Kyung-Wuk, Suh Sang-Ho
Department of Mechanical Engineering, Soongsil University, Seoul, Korea.
Department of Radiology, Seoul National University Boramae Hospital, Seoul, Korea.
Technol Health Care. 2017 Jul 20;25(S1):63-72. doi: 10.3233/THC-171307.
Ureteral stenosis presents with a narrowing in the ureter, due to an intrinsic or extrinsic ureteral disease, such as ureter cancer or retroperitoneal fibrosis. The placement of a double J stent in the upper urinary system is one of the most common treatments of ureteral stenosis, along with the insertion of a percutaneous nephrostomy tube into the renal pelvis. The effect that the side holes in a double J stent have on urine flow has been evaluated in a few studies using straight ureter models. In this study, urine flow through a double J stent's side holes was analyzed in curved ureter models, which were based on human anatomy. In ureteral stenosis, especially in severe ureteral stenosis, a stent with side holes had a positive effect on the luminal and total flow rates, compared with the rates for a stent without side holes. The more side holes a stent has, the greater the luminal and total flow rates. However, the angular positions of the side holes did not affect flow rate. In conclusion, the side holes in a double J stent had a positive effect on ureteral stenosis, and the effect became greater as the ureteral stenosis became more severe.
输尿管狭窄表现为输尿管出现狭窄,这是由输尿管自身或外部疾病引起的,如输尿管癌或腹膜后纤维化。在上尿路系统中放置双J支架是输尿管狭窄最常见的治疗方法之一,同时还包括在肾盂中插入经皮肾造瘘管。一些使用直输尿管模型的研究已经评估了双J支架侧孔对尿液流动的影响。在本研究中,基于人体解剖结构的弯曲输尿管模型分析了流经双J支架侧孔的尿液流动情况。在输尿管狭窄中,特别是在严重输尿管狭窄时,与无侧孔支架相比,有侧孔支架对管腔和总流速有积极影响。支架的侧孔越多,管腔和总流速越大。然而,侧孔的角度位置并不影响流速。总之,双J支架的侧孔对输尿管狭窄有积极影响,且随着输尿管狭窄程度加重,这种影响会更大。