Urodynamics

List of Contributors

Preface

I. Ureteral Morphology as a Basis for Peristaltic Activity: Basic Principles


1. Ureteral Embryology, Developmental Anatomy, and Myology

Gross Anatomy

Microscopic Structure

Specific Features

References


2. The Neurohistochemistry of Mammalian Ureter

Materials and Methods

Results

Model of Innervation to the Ureter

Conclusions

References


3. Some Biophysical Aspects of Ureter Smooth Muscle

Text

Summary

References


4. A Comparison of Other Conduit Organs with the Ureter: Reaching toward a Clearer Concept of Ureteral Peristalsis

Models

Conclusions

Bibliography


5. The Renal Pelvis and Calyces

Text

References

Discussion

II. The Concept of Ureteral Peristaltic Function


6. Cineradiographic Observations of Ureteral Functions in Man and Dog

Discussion

Summary

References


7. Ureteral Delivery and Efflux

Methods

Results

Discussion

Summary

References


8. Ureteral Peristaltic Pressure Methods

Direct Observation

Examination of Ureteral Efflux

X-Ray Techniques

Electromanometry or Ureteral Peristaltic Pressure Method

Ureteral Perfusion

In Vitro Methods

Tissue Culture

Biochemical Assays

Histology and Histochemistry

Pharmacologic Methods

Electromyography

Preparations for Study of the Ureter

References


9. Ureteral Peristaltic Activity

Activity with Low Rates of Urine Flow

Normal Hydration

Retrograde Flow

Effect of Bladder Distention

Diuresis

Effect of Mechanical Stimulation

Effect of Mechanical Obstruction

Effect of Gravity

Conclusion


10. The Isoloted Ureter in Vitro

Text

Summary

References


11. Correlation of Cineradiographic Image and Pressure Tracing of Ureteral Peristalsis

Method

Results

Summary

Conclusion

Bibliography


12. Electrophysiological Methods in the Study of Ureteral Dynamics

Materials and Instruments

Methods

Discussion and Conclusions

References

Discussion

III. Bioengineering Aspects of Ureteral Function


13. Ureteral Dimensions and Specifications for Bioengineering Modeling

Text

Bibliography


14. Basic Engineering Principles of Ureteral Flow

Analysis

Summary

References


15. Peristaltic Pumping: A Bioengineering Model

Simplifying Assumptions

Analysis

The Muscle Action

Numerical Procedure

Results

Conclusion

Appendix

References


16. The Ureter as a Peristaltic Pump

The Ureter as a Uniform Circular Collapsing Tube

The Ureter as a Traveling Sinusoidal Wave

The Ureter as a Traveling Wave of Arbitrary Shape

Comparison of the Theory with Experiments

Conclusions and Future Work

References


17. Hydrodynamic Model of Ureteral Function

Objectives

Previous Work

Data for the Human Ureter

Calculational Model of the Ureter

Results

Conclusions

Appendix

References


18. A Systems Physiology Approach to Ureteral Modeling

Text

References

Discussion

IV. Factors Controlling Ureteral Peristalsis


19. Neurophysiological Theory of Ureteral Function

Text

Bibliography


20. Physiological Organization of Function with Reference to a Pacemaker

Ionic Hypothesis for Electrical Activity

Propagation of Electrical Activity

Ionic Basis for Ureteral Electrical Activity

Propagation of Ureteral Electrical Activity

Pacemaker Activity

Excitation-Contraction Coupling

Summary

References


21. The Ureteral Response to Bladder Filling

Direct Observations of the Ureterovesical Orifice in Man

Observations of Ureteral Activity during Bladder Filling, Micturition, and Sustained Pressure

Summary

References


22. The Relation of Ureteral Function lo Urine Flow: Backflow Mechanisms

Text

References


23. A Review of Intrarenal Hemodynamics and Hydrodynamics

Pressure Profiles along the Renal Vasculature and the Uriniferous Tubules

The Nephron

The Effects of Ureterai Occlusion on Intrarenal Pressures

Reabsorption of Salt and Water by the Uriniferous Tubules

Summary

References


24. Partial Ureterai Obstruction and Renal Function

Glomerular Filtration Rate

Concentrating Ability

Complete Obstruction and Reabsorption Replacement

Summary

References


25. Drugs, Hormones, and Endotoxin Effects: Speculations on the Molecular Biology of Ureterai Peristalsis

Text

References

Discussion

V. Clinical Applications


26. Diagnostic Methods for Ureterai Peristalsis: Critique and Limitations

The History

Physical Examination

Direct Observation

Cystoscopic and Chromocystoscopic Observation

Radiologic Studies

Ureteral Pressure Recording

References


27. Laboratory Models of Diseases Altering Ureteral Hydrodynamics

Text

Bibliography


28. Peristalsis in the Diseased Ureter: A Brief Summary of Current Knowledge

The Obstructed Ureter

Transected or Injured Ureter

Effects of Disuse and Overuse on the Ureteral Wall

The Bifid Ureter

Inflammatory Effects on Peristalsis

Ureteral Regeneration

Summary

References


29. Factors Promoting Recovery of Function in the Diseased and Operated Ureter

Text

Bibliography

Discussion

VI. Theory and Techniques of Hydrodynamic Measurements


30. Modal Activity of Ureteral Peristalsis

Method

Discussion

Results

Summary and Conclusions

References


31. Ureteral Pressure Measurements

Pressure

Measurement of Pressure

Interrelations between Pressure Measurements and Other Forms of Study

References


32. Factors in the Development of Measurement Techniques for Transcutaneous Studies of Ureter Function

Basic Concepts That Should Be Adhered to

The Feasibility of Implementing These Criteria

The Development of Transcutaneous Techniques

Phase I of Transcutaneous Ureter Function Measurements Development Sequence

Phase II of Transcutaneous Ureter Function Measurements Development Sequence

Phase III of Transcutaneous Ureter Function Measurements Development

Sequence

Summary

References

Discussion

VII. Potential Adaptation of Available Instrumentation and Techniques Not Currently Used


33. Real-Time Digital Computer System for Ureteral Physiology Investigation

Experimental Procedure

Instrumentation

Data Flow

Computation and Results

Correlation Analysis and Discussion

Conclusion

References


34. Electrical Measurement of Ureteral Flow

Measurement of Ureteral Cross Sections

Physical Considerations and Sources of Error

Systems Considerations


35. A Microminiaturized Piezojunction Pressure Sensor

Text

References


36. Ureteral Plethysmography

Technique

Results

Reference


37. Information Theory and the Ureter: A Hydrodynomic Point of View

Variation of Hydrodynamic Information

A Simple System for Peristaltic Pumping

Data Analyzing

Pressure Gradient and Secondary Flow in the Bolus

References


38. Ureteral Pacemaker

Text

References


39. Observations on the Ureter after Renal Autotransplantation

Methods and Materials

Operative Technique

Follow-Up Studies

Results

Discussion

Summary

Bibliography


40. Heal Sleeve Procedure for the Decompensated Ureter

Text


41. Ureteral Replacement by lleum

Text

References


42. The Silastic Ureter

Text

References


43. Use of the Internal Ureteral Stent in Surgery of the Kidney and Ureter

Method

Functions of the Internal Stent

Complications of Internal Stents

Bibliography

Panel Discussion

Summary and Evaluation

Subject Index