Abstract
The ureterovesical pressure profile (UVPP) and the dynamics of the urterovesical junction (UVJ) were analysed with prevesical and intraluminal perfusion pressure measurements, and with an intraluminal micro-pressure sensor catheter.
The reliability of the measuring techniques was evaluated with different pressure measuring catheters under varying conditions.
Prevesical and intraluminal perfusion pressure measurements with F8 or F5 flexible catheters, at high perfusion rates, and intermittent or low withdrawal velocity of the catheter, produced the highest reproducibility.
The dynamical factors and anatomical structures, which possibly contribute to, or influence the pressure phenomena within the UVJ, were evaluated by the principle of addition and elimination.
Besides a baseline pressure, the UVPP showed fast and slow pressure waves. The UVJ develops peristaltic activity by which it discharges fluid boli into the bladder. This UVJ peristalsis is responsible for the fast pressure waves in the UVPP.
The slow pressure waves represent the influence of detrusor activity upon urine transport through the UVJ, and reflect detrusor irritability.
Besides activity arteficially induced by an intraluminal catheter, the baseline pressure represents the resistance to continuous flow through the UVJ. It is determined by:
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The intravesical pressure in the bladder at bladder filling.
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The detrusor activity in the unexpanded bladder.
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The bladder wall stretch in the overdistended bladder.
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The bladder wall stress and intravesical pressure in the small volume, low capacity bladder.
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Similar pressure measurements in man seem to confirm these findings.
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Blok, C., van Venrooij, G.E.P.M., Coolsaet, B.L.R.A. (1985). Dynamics of the Ureterovesical Junction. In: Lutzeyer, W., Hannappel, J. (eds) Urodynamics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-70436-9_16
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DOI: https://doi.org/10.1007/978-3-642-70436-9_16
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