Abstract
Urine, as a byproduct of the filtration function of the kidney, exits from the papillae and is stored by the bladder to be released at the appropriate time by voluntary micturition. The mechanisms involved in accomplishing this journey are facilitated by the participation of several different anatomical structures. At this juncture, the nephrological function of the kidney is essentially completed, and the urodynamic aspects of the upper urinary tract begin. In this chapter, consideration is made of the transport mechanism responsible for the smooth propagation of urine from the upper to the lower urinary tract. Initiation of urine transport is triggered by a pacemaker system located in the renal pelvis. The mechanisms responsible in regulating ureteral peristalsis are primarily myogenic, initiated by active pacemaker cells located in the renal pelvis. In this chapter, emphasis is given to the hydrodynamic factors of urine flow rate in determining the initiation size and pattern of urine boluses influencing the mechanical aspects of peristaltic rhythm, rate, amplitude, and pressure. Issues to be considered are basically centered as to how ureteral peristalsis is initiated in the renal pelvis by examining the properties of individual regions of the smooth muscle of the urinary tract. In this way, an evaluation is made of the properties of the smooth muscle strips of tissue from different regions of the pelvis in both the uni- and multicalyceal kidney. This chapter describes how the individual response of these tissues is endowed with unique mechanical and pharmacologically properties constituting a pacemaker system responsible in the initiation of transport in the urinary tract. It is expected that, by assembling the rhythmic components of the renal pelvis to provide a better understanding of the mechanism of how a bolus is launched in the upper urinary tract.
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Constantinou, C.E. (2023). Upper Urinary Tract Urodynamics: Initiation of Peristalsis in the Upper Urinary Tract. In: Liao, L., Madersbacher, H. (eds) Handbook of Neurourology. Springer, Singapore. https://doi.org/10.1007/978-981-99-1659-7_70
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DOI: https://doi.org/10.1007/978-981-99-1659-7_70
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