Changes of the ureteral movement in diuretic condition and after ureteral surgery.

KUBO, T., SASAKI, S., NUMASATO, S., TAKAHASHI, S. and AKASAKA, T. Changes of the Ureteral Movement in Diuretic Condition and after Ureteral Surgery. Tohoku J. exp. Med., 1977, 123 (1), 9-22 An extraluminal ureteral bipolar needle "indwelling" electrode with recording wire was devised to study the ureteral function, and daily recording of the ureteral myogram in human and experimental animal has been successfully carried out. Using this new electrode, ureteral myogram and intraureteral pressure were simultaneously recorded in humans and dogs under various experimental conditions, and the following results were obtained: (1) The average ratio of peristaltic frequency of the renal pelvis to that of the ureter was 3:1 under ordinary diuretic condition. Following Furosemide administration, the peristaltic frequency of the renal pelvis remained unchanged while both the intrapelvic pressure and the peristaltic frequency of the ureter increased, with an average ratio of 1:1. (2) When the middle portion of the ureter was transected and anastomosed with a vinyl ureteral catheter to block the myogenic conduction, an excitation was evoked at the stump of the lower ureter by the stimulation of urinary flow and almost normal peristalsis was observed. There was no relationship in the direction of peristalsis between the lower ureter and the rest of the ureter. (3) Following operation of the ureters in dogs, ureteral myograms were recorded daily. Abnormal discharges were evoked immediately after surgery in the lower part of the ureter below the surgical site. After urinary fistula formation in humans, abnormal discharges were more frequently observed, and at the same time the ureteral peristalsis across the surgical site was decreased. These abnormal discharges disappeared by 7 days after surgery in the group without postoperative fistula formation, but in the humans with urinary fistulation they disappeared only after the fistula was healed. (4) The rate of peristalsis through the surgical site of the canine ureter was greater than 50% in the group without hydronephrosis, but less than 50% in the group with postoperative hydronephrosis. Therefore, it was assumed that postoperative hydronephrosis due to ureteral obstruction would not occur, if the peristaltic rate is maintained greater than 50%. -ureter; renal pevlis; electromyogram; intraluminal pressure