Noro K, Kawamura S
Department of Uroogy, Iwate Medical University.
J Smooth Muscle Res. 1996 Feb;32(1):9-16. doi: 10.1540/jsmr.32.9.
This study is to determine which part or the upper urinary tract, ureter or pelvis causes more significant delay in the pressure wave-front propagation from the bladder to the pelvis when a reverse flow of the urine occurs. A sudden rise in the intravesical pressure of the dog was produced by stimulating the vesical branches of pelvic nerve with a train of electrical impulses with 10 Hz for 60 sec. In order to eliminate the physiological mechanism that presents a reverse flow of the urine at the uretero-vesical junction, a 3 cm vinyl tube was inserted into the ureteral orifice in all experiments except the cases with ureteral substitution (group II and III). Changes in intrapelvic pressure were measured from 7 dogs without substitution of either ureter or pelvis, and used as the control responses for comparison with those recorded from the dogs with artificial ureter and/or pelvis. Artificial ureter was made by a vinyl tube of 25 cm, whereas artificial pelvis was made by a 3 ml plastic chamber. Twenty-eight dogs were divide into 3 groups. Group I consisted of 7 dogs whose pelvises were replaced by artificial ones. Group II included 8 dogs whose ureters were substituted by artificial ones, and group III consisted of 6 dogs whose both ureter and pelvis were replaced by artificial ones. Results obtained were as follows; (1) There was no significant difference between the maximum intravesical pressure and the maximum intrapelvic pressure recorded from every dog in all groups. (2) The onset time of intrapelvic response recorded from the control dog showed a delay from that of intravesical response by 2.05 +/- 1.03 sec. (3) The onset time of intrapelvic response recorded from group I, II and III were 0.51 +/- 0.94 sec., 1.95 +/- 1.10 sec., 0.10 +/- 0.25 sec., respectively. (4) Statistically significant difference in the delay of response was observed only between the responses recorded from the control or group II and the responses recorded from group I or III. The above results suggested that the major site causing a significant delay in the pressure wave-front propagation from the bladder to the pelvis is the pelvic area including caryx, but not the ureteral region, when a reverse flow of the urine occurs.
本研究旨在确定当尿液出现逆流时，上尿路的哪个部分，即输尿管或肾盂，会在压力波前从膀胱传播至肾盂的过程中造成更显著的延迟。通过以10赫兹的电脉冲串刺激盆神经的膀胱支60秒，使狗的膀胱内压突然升高。为了消除输尿管膀胱连接处出现尿液逆流的生理机制，除输尿管替代的情况（第二组和第三组）外，在所有实验中均将一根3厘米的乙烯基管插入输尿管口。对7只未进行输尿管或肾盂替代的狗测量肾盂内压力变化，并将其用作对照反应，与人工输尿管和/或人工肾盂的狗所记录的反应进行比较。人工输尿管由一根25厘米的乙烯基管制成，而人工肾盂由一个3毫升的塑料腔制成。28只狗被分为3组。第一组由7只肾盂被人工肾盂替代的狗组成。第二组包括8只输尿管被人工输尿管替代的狗，第三组由6只输尿管和肾盂均被人工替代的狗组成。获得的结果如下：（1）所有组中每只狗记录的最大膀胱内压和最大肾盂内压之间无显著差异。（2）对照狗记录的肾盂反应起始时间比膀胱反应起始时间延迟2.05±1.03秒。（3）第一组、第二组和第三组记录的肾盂反应起始时间分别为0.51±0.94秒、1.95±1.10秒、0.10±0.25秒。（4）仅在对照或第二组记录的反应与第一组或第三组记录的反应之间观察到反应延迟的统计学显著差异。上述结果表明，当尿液出现逆流时，在压力波前从膀胱传播至肾盂过程中造成显著延迟的主要部位是包括肾盏的肾盂区域，而非输尿管区域。
