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Ureteric jet in the anaesthetised child

Vivian Yee Fong Leung1, Con Metreweli, Chung Kwong Yeung

  • 1Diagnostic Radiology and Organ Imaging Department, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. leuyf2@ctimail.com

Ultrasound in Medicine & Biology
|October 14, 2003
PubMed

Insights

Anesthesia affects the human vesicoureteral junction (VUJ) sphincteric mechanism. Anesthesia caused a loss of the complex ureteric jet pattern, indicating a modification of VUJ function.

Area of Science:

  • Urology
  • Pediatric Surgery
  • Physiology

Background:

  • The human vesicoureteral junction (VUJ) possesses an active bimodal sphincteric mechanism.
  • This mechanism is known to be influenced by factors such as immaturity, hormones, and surgical interventions.

Purpose of the Study:

  • To investigate the impact of anesthesia on the sphincteric mechanism of the VUJ.
  • To determine if anesthesia alters the ureteric jet patterns indicative of VUJ function.

Main Methods:

  • Utilized color and pulse wave Doppler to record ureteric jets in 16 pediatric patients before and after anesthesia.
  • Patients were well-hydrated during the study period.

Main Results:

  • Prior to anesthesia, 14 children exhibited mature (complex pattern) ureteric jet waveforms, while two showed immature (monophasic pattern) waveforms.
  • Following anesthesia, all 16 children demonstrated a monophasic waveform (p=0.01).
  • Anesthesia led to a loss of the complex pattern, modifying the sphincteric action of the VUJ.

Conclusions:

  • Anesthesia significantly modifies the sphincteric action of the VUJ, as evidenced by the loss of complex ureteric jet patterns.
  • The findings support the hypothesis that the complex jet pattern represents neural modulation of the myogenic mechanism responsible for the monophasic jet.

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