Juskiewenski S, Vaysse P, Moscovici J, de Graeve P, Guitard J
Anat Clin. 1984;5(4):251-9. doi: 10.1007/BF01798748.
The ureterovesical junction was studied by dissection and serial sections in 50 post mortem specimens. Three points are considered in this paper: the structure of the terminal ureter, the anatomical arrangement of the ureteral hiatus and the ureteral sheath. Study of the structure of the intramural segment of the ureter demonstrated on one hand, the perfect continuity of the terminal ureter with the trigone and on the other hand, the abundance of the fibroelastic connective fibers which like the muscle fibers run longitudinally. The compliance of the intravesical ureter is dependent on the balance between these two components. The modification of this balance can lead to the creation of a functional obstacle. The anatomical arrangement of the ureteral hiatus is described. The inner muscle layer of the detrusor extends almost to the ureteral orifice, the truly submucosal part of the ureter thus being very small. The constitution of the ureteral orifice and its relations to the ureter account for the different positions of juxtaureteral diverticula and transhiatal herniae of the bladder mucosa. The many descriptions of the ureteral sheath appearing in the literature are reviewed in light of the findings from the present study. The juxtavesical segment of the ureter is surrounded by a fibroconjunctive sheath which fixes the ureter to the bladder wall. The transparietal segment of the ureter is ensheathed in its adventitia, whereas a fibromuscular sheath cannot be truly individualized over this ureteral segment.
通过对50例尸检标本进行解剖和连续切片，研究了输尿管膀胱连接部。本文考虑了三点：输尿管末端的结构、输尿管裂孔的解剖学排列以及输尿管鞘。对输尿管壁内段结构的研究表明，一方面，输尿管末端与膀胱三角区完美连续；另一方面，存在丰富的纤维弹性结缔组织纤维，这些纤维与肌纤维一样纵向走行。膀胱内输尿管的顺应性取决于这两个成分之间的平衡。这种平衡的改变可导致功能性障碍的产生。描述了输尿管裂孔的解剖学排列。逼尿肌的内层几乎延伸至输尿管口，因此输尿管真正的黏膜下层部分非常小。输尿管口的构成及其与输尿管的关系解释了输尿管旁憩室和膀胱黏膜经裂孔疝的不同位置。根据本研究的结果，对文献中出现的关于输尿管鞘的诸多描述进行了综述。输尿管膀胱旁段被一层纤维结缔组织鞘包围，该鞘将输尿管固定于膀胱壁。输尿管经壁段被其外膜包裹，而在该输尿管段无法真正区分出纤维肌鞘。
