Galal H, Lazica A, Lampel A, el Guiochi F, Schubert G E, Thüroff J, Khalaf I
Urology Department, Al Azhar University, Cairo, Egypt.
J Endourol. 1993 Oct;7(5):411-7. doi: 10.1089/end.1993.7.411.
Ureteral strictures were induced experimentally by unilateral partial ligation of the upper ureter on the left side in 56 female rabbits. Six weeks later, stricture stability was documented by intravenous urography. In all cases, there was fibrosis of the muscular wall of the ureter. The lumen, although narrowed to various degrees, was preserved in most animals, and moderate to marked hydronephrosis resulted. Control animals were not treated in order to study the natural progress of the stricture. The other strictures were treated either by dilation (catheter or balloon) with or without ureteral stenting, by intubated external ureterotomy, or by excision of the strictured segment and stented end-to-end anastomosis. Follow-up studies consisted of intravenous urography, renography, and histologic examination for 24 weeks. Ureteral dilation without and with 2 weeks of stenting could be an adequate treatment of strictures associated with a moderate degree of hydronephrosis. Intubated external ureterotomy did not give satisfactory results in any animal. Excision of the strictured segment with a stented anastomosis produced satisfactory results and has a great role in the treatment of the strictured ureter in comparison with the variable outcome of endourologic treatment. Stenting of the unobstructed ureter, tested in six rabbits, showed a positive correlation between renal obstruction and long-term ureteral stenting.
通过对56只雌性兔子左侧输尿管上段进行单侧部分结扎，实验性诱导输尿管狭窄。六周后，通过静脉肾盂造影记录狭窄稳定性。在所有病例中，输尿管肌壁均有纤维化。管腔虽然不同程度地变窄，但在大多数动物中得以保留，导致中度至重度肾积水。为了研究狭窄的自然进展，未对对照动物进行治疗。其他狭窄则通过扩张（导管或球囊）加或不加输尿管支架置入、插管式输尿管外切开术，或切除狭窄段并进行支架端端吻合术进行治疗。随访研究包括静脉肾盂造影、肾图检查和24周的组织学检查。输尿管扩张不加支架和加支架2周可能是治疗伴有中度肾积水的狭窄的适当方法。插管式输尿管外切开术在任何动物中均未取得满意结果。切除狭窄段并进行支架吻合术取得了满意结果，与腔内泌尿外科治疗的可变结果相比，在治疗狭窄输尿管方面具有重要作用。在6只兔子中测试的通畅输尿管支架置入显示，肾梗阻与长期输尿管支架置入之间存在正相关。
