el-Deen M E, Khalaf I, Rahim F A
Department of Urology, Al-Azhar University, Cairo, Egypt.
J Endourol. 1993 Oct;7(5):399-405. doi: 10.1089/end.1993.7.399.
The effects of internal stenting of a normal ureter on the upper urinary tract were studied in 34 male rabbits by plain films, intravenous urograms, and 99mTc-DTPA renography at weekly intervals. Moreover, pressure-flow studies of the upper urinary tract were performed, and urine specimens for culture were obtained preoperatively and at the time of sacrifice. Histopathologic examination of the kidney, ureter, and ureterovesical junction was performed after animal sacrifice. Hydroureteronephrosis and stasis with equivocal obstruction were noted after 1 week of stenting. These changes were reversible after stent removal. Prolonged stenting (> 3 weeks) produced moderate to severe hydroureteronephrosis, and renal function was lost in 2 of 18 renal units because of severe hydronephrosis or infection. Ureteral stenting did not produce obstruction at a flow rate as high as 8 ml/minute. Histopathologic examination showed dilation of the pelvicaliceal system and renal tubules, infiltration of the kidney and the ureter with inflammatory cells, mucosal ulceration, and muscular hypertrophy of the ureters. The bladder mucosa showed a severe inflammatory reaction, Brunn nests, and ulceration with occasional metaplasia. Stenting of normal ureters in rabbits produced no harmful effects on the kidney if the stents were removed within 1 week, but prolonged stenting could affect renal and ureteral integrity.
通过X线平片、静脉肾盂造影以及每隔一周进行一次的99mTc-DTPA肾图，对34只雄性兔正常输尿管内支架置入对上尿路的影响进行了研究。此外，还对上尿路进行了压力-流量研究，并在术前及处死时获取尿培养标本。动物处死后对肾脏、输尿管及输尿管膀胱连接部进行了组织病理学检查。支架置入1周后可见输尿管肾盂积水和伴有可疑梗阻的尿液潴留。取出支架后这些改变是可逆的。长时间支架置入（>3周）导致中度至重度输尿管肾盂积水，18个肾单位中有2个因严重肾积水或感染而失去肾功能。输尿管支架置入在高达8毫升/分钟的流速下未产生梗阻。组织病理学检查显示肾盂肾盏系统和肾小管扩张，肾脏和输尿管有炎性细胞浸润、黏膜溃疡以及输尿管肌层肥厚。膀胱黏膜出现严重炎症反应、布伦巢以及伴有偶尔化生的溃疡。兔正常输尿管置入支架，如果在1周内取出，对肾脏无有害影响，但长时间支架置入会影响肾脏和输尿管的完整性。
