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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
Summary
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.