Osterhage H R
Fortschr Med. 1981 Jun 4;99(21):824-8.
Intrauterine operations were carried out in fetal sheep varying from 50-122 days of gestation. Silk, catgut and polyglycolicacid sutures were used to produce varying degrees of stenosis. The urachus was ligated with a silk suture in all cases. Urachal ligation alone produces no ill effects on the upper urinary tract. The addition of urethral stenosis results in dilatation of the upper tract depending on the degree of infravesical obstruction. Partial ligation of the urethra produces a pyelocalyectasis which may disappear later. More severe degrees of obstruction are followed by hydronephrosis, hydroureter and megacystis. Dilatation begins in the region of the renal pelvis and proceeds in the antegrade manner towards the bladder. Histologically the parenchyma was reduced in thickness and showed dilated tubules. In the ureter and the bladder muscular hypertrophy was noticed. Depending on the time of the experiment, there was an increase of connective tissue within the ureter and bladder. In cases of extreme obstruction the ureter showed muscular atrophy. No infection, ureteral reflux, bladder diverticulosis, extravesicalisation of the ureter or narrowing of the ureter by hypertrophied musculature was seen. These experiments may throw some light on the pathogenesis of the megaureter syndrome occurring in childhood.
对妊娠50至122天的胎羊进行宫内手术。使用丝线、肠线和聚乙醇酸缝线造成不同程度的狭窄。所有病例均用丝线结扎脐尿管。单独结扎脐尿管对上尿路无不良影响。加上尿道狭窄会导致上尿路扩张，这取决于膀胱下梗阻的程度。部分结扎尿道会导致肾盂肾盏扩张，之后可能会消失。更严重程度的梗阻会导致肾积水、输尿管积水和巨膀胱。扩张始于肾盂区域，并以顺行方式向膀胱发展。组织学上，实质厚度变薄，肾小管扩张。在输尿管和膀胱中发现肌肉肥大。根据实验时间，输尿管和膀胱内的结缔组织会增加。在极端梗阻的情况下，输尿管会出现肌肉萎缩。未发现感染、输尿管反流、膀胱憩室、输尿管膀胱外移位或因肌肉肥大导致的输尿管狭窄。这些实验可能有助于阐明儿童期巨输尿管综合征的发病机制。
