Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain.
Department of Urology, University Hospital de la Princesa, Madrid, Spain.
Urol Int. 2021;105(7-8):554-559. doi: 10.1159/000515613. Epub 2021 May 5.
The aim of this experimental study is to assess, in a porcine model, the onset and grades of vesicoureteral reflux associated with ureteral stents.
Twenty-four female porcine models were used. A 4.7-Fr ureteral stent was placed in all right ureters and kept in place for 6 weeks. Follow-ups were performed on weeks 1, 3, 6, and 12. Ultrasonography, cystoscopy, and fluoroscopy were used to analyze grade of hydronephrosis, presence and grade of vesicoureteral reflux, bacteriuria, and macroscopic changes of the ureteral orifices. Vesicoureteral reflux was classified using a modification of the International Reflux Study Committee grades.
91.7% animals present vesicoureteral reflux, 89.5% grade IA, 3.5% grade IB, and 7% grade II. There is a significant increase in reflux during follow-ups at 3 and 6 weeks, whereas 6 weeks after removal, 26.3% of the ureters still present vesicoureteral reflux. Hydronephrosis and macroscopic changes of the ureteral orifice increase significantly with stenting, but there is no significant association between them and vesicoureteral reflux; the relationship between bacteriuria and the presence of vesicoureteral reflux is not significant either.
Vesicoureteral reflux caused by ureteral stents in an animal model is mostly low grade and mainly affects the distal ureter.
本实验研究旨在评估猪模型中与输尿管支架相关的输尿管反流的发生和程度。
使用 24 只雌性猪模型。所有右侧输尿管均放置 4.7Fr 输尿管支架，留置 6 周。在第 1、3、6 和 12 周进行随访。使用超声、膀胱镜和透视检查来分析肾积水程度、存在和程度的输尿管反流、菌尿和输尿管口的宏观变化。输尿管反流采用国际反流研究委员会分级的改良方法进行分类。
91.7%的动物出现输尿管反流，89.5%为 IA 级，3.5%为 IB 级，7%为 II 级。在第 3 周和第 6 周的随访中，反流明显增加，而在去除后 6 周，仍有 26.3%的输尿管存在输尿管反流。随着支架的留置，肾积水和输尿管口的宏观变化显著增加，但与输尿管反流之间没有显著关联；菌尿与输尿管反流的存在之间也没有显著关系。
动物模型中输尿管支架引起的输尿管反流主要为低级别，主要影响输尿管远端。
