Makosiej Ryszard, Orkisz Stanisław, Czkwianianc Elżbieta
Department of Gastroenterology, Allergology and Pediatrics, Research Institute, Polish Mother Memorial Hospital, Lodz, Poland.
Department of Human Anatomy Medical University, Rzeszow, Poland.
J Anat. 2018 Mar;232(3):449-456. doi: 10.1111/joa.12752.
Morphological and morphometric assessment of the elements of the ureterovesical junction in children was performed in the present study in different age groups ranging from 24 weeks of gestation to 16 years old. We tried to answer the question whether, in human ontogenesis, there is a period of anatomical predisposition to primary vesicoureteral reflux. The study included 210 urinary bladders with juxtavesical parts of the ureters that had been obtained from routine autopsies. As a result of the study, we showed that provided the pregnancy is uncomplicated there is no inherited susceptibility that would account for reducing or disturbing the development of ureterovesical junction elements. Based on the analysis of our results concerning the anatomy and morphological changes taking place in the elements of the ureterovesical junction in different age groups, one could put forward a hypothesis that anatomical predisposition to primary vesicoureteral reflux occurs in age group II, i.e. between 28 and 37 weeks of gestation. The parameters that define interrelations between elements of the ureterovesical junction and that are considered essential for normal functioning of antireflux mechanism were still observed in age group VI in our study. This suggests that these relations are not unambiguous in children with normally structured and functionally competent vesicoureteral junction.
本研究对妊娠24周龄至16岁不同年龄组儿童的输尿管膀胱连接部各结构进行了形态学和形态测量学评估。我们试图回答在人类个体发育过程中是否存在原发性膀胱输尿管反流的解剖学易患期这一问题。该研究纳入了210个带有输尿管膀胱旁部分的膀胱,这些标本取自常规尸检。研究结果表明,在孕期无并发症的情况下,不存在可解释输尿管膀胱连接部结构发育减少或紊乱的遗传易感性。基于对不同年龄组输尿管膀胱连接部结构的解剖学及形态学变化结果的分析,我们可以提出一个假设,即原发性膀胱输尿管反流的解剖学易患期出现在II年龄组,即妊娠28至37周之间。在我们的研究中,定义输尿管膀胱连接部各结构之间相互关系且被认为对抗反流机制正常功能至关重要的参数,在VI年龄组中仍可观察到。这表明,在输尿管膀胱连接部结构正常且功能良好的儿童中,这些关系并不明确。