Rognon L, Soret J Y, Michaud P, Lavenet J, Cronier P
J Urol Nephrol (Paris). 1979 Oct-Nov;85(10-11):683-7.
The authors, anxious about the crossed position of the ureteric meatuses after transverse submucosal advancement of the ureters, prefer descending submucosal advancement. They emphasise the widely open nature of the hiatus of penetration of the ureter into the bladder. Tightening of this orifice, distal to the orifice left free for the penetration of the ureter, participates in elongation backwards of the muscular layer upon which the submucosal advancement will take place. If necessary, if the trigone is too short, the vesical muscularis layer is slit in a proximal direction, uretero-vesical penetration withdrawn by an equal amount and suture of the muscular breach behand the ureter elongates a submucosal course which, without the use of this technique, would be too short. The authors have collected a series of 63 ureters. No stenosis, 3 residual reflux and at the time of follow up cystoscopy where applicable, the new meatus is easy to locate and to catheterise.
作者们因输尿管经黏膜下横向推进后输尿管口的交叉位置而感到担忧，故而更倾向于下行黏膜下推进。他们强调输尿管穿入膀胱处裂隙的广泛开放性质。在为输尿管穿入留出的开口远端收紧此孔，会促使黏膜下推进所依托的肌肉层向后延长。如有必要，若三角区过短，则向近端切开膀胱肌层，将输尿管膀胱穿入处等量上提，并缝合输尿管后方的肌肉裂口，这样能延长黏膜下行程，若不采用此技术，该行程会过短。作者们收集了63条输尿管的病例系列。无狭窄情况，有3例残留反流，在适用时进行随访膀胱镜检查时，新的输尿管口易于定位和插管。
