The urodynamic relationship of renal pelvic and bladder pressures, and urinary flow rate in rats with congenital vesicoureteral reflux
The urodynamic relationship of renal pelvic and bladder pressures, and urinary flow rate in rats with congenital vesicoureteral reflux
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DOI：
10.1016/s0022-5347(01)63074-x
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发表时间：
1998-07-01
影响因子：
6.6
通讯作者：
Shortliffe, LD
中科院分区：
文献类型：
--
作者：
Angell, SK;Pruthi, RS;Shortliffe, LD
目的：我们确定有或没有膀胱输尿管反流的通畅大鼠中肾盂和膀胱压力与不同尿流率和膀胱充盈度的关系。材料和方法：对 Sprague-Dawley 大鼠（180 至 250 gm）进行膀胱输尿管反流评估，然后在膀胱充盈周期期间同时连续监测肾盂和膀胱压力。结果：先天性右侧膀胱输尿管反流的发生率为 25%（57 只大鼠中的 14 只，膀胱压力低于 40 厘米水）。与正常大鼠相比，反流大鼠的肾盂压力仅在膀胱充满90％或以上且尿量中等且膀胱充满50％或以下时尿量非常低时才显着升高。对于所有其他尿量和膀胱充盈程度，有反流和无反流的大鼠之间的盆腔压力没有显着差异。结论：除了明确的条件外，轻度至中度反流大鼠的反流和非反流集合系统中的肾盆腔压力没有差异。当尿流率很低时，可以通过升高膀胱内压来诱发反流。此外，死后膀胱输尿管反流压力降低。因此，膀胱输尿管反流的观察是一种由尿流率、膀胱压力和体内条件定义的相对现象，并且必须定义反流发生时存在的具体膀胱压力和尿流率。这些数据有助于解释为什么在各种影像学研究中观察到的反流可能是间歇性的或短暂的。
Purpose: We define the relationship of renal pelvic and bladder pressures with varying urinary flow rates and bladder fullness in unobstructed rats with and without vesicoureteral reflux.Materials and Methods: Sprague-Dawley rats (180 to 250 gm.) were evaluated for vesicoureteral reflux followed by simultaneous and continuous renal pelvic and bladder pressure monitoring during bladder filling cycles.Results: The incidence of congenital right vesicoureteral reflux was 25% (14 of 57 rats, below bladder pressure of 40 cm. water). The renal pelvic pressure was significantly higher in rats with reflux compared to normal rats only at very low urine output when the bladder was 90% full or greater and when the urine output was moderate with the bladder 50% full or less. For all other urine outputs and degrees of bladder fullness, there were no significant differences in pelvic pressure between rats with and without reflux.Conclusions: Renal pelvic pressures in the refluxing and nonrefluxing collecting system of rats with mild to moderate reflux do not differ except under well-defined conditions. Reflux can be induced by raising the intravesical pressure when the urinary flow rate is very low. Furthermore, vesicoureteral reflux pressures decrease post mortem. Therefore, the observation of vesicoureteral reflux is a relative phenomenon defined by urinary flow rate, bladder pressure and in vivo conditions, and one must define the specific bladder pressure and urinary flow rate that are present when reflux occurs. These data help explain why the observation of reflux may be intermittent or transient during various imaging studies.