Urometric evaluation of intramural ureter function with continual ureteral perfusion

Urometry provides a valuable test of ureteral function wherein intraureteral pressure changes associated with ureteral peristaltic contraction are recorded via a fine catheter inserted through the bladder into the ureter. An attempt was made to evaluate the function of the intramural ureter by analysis of urometric wave pattern of resting pressure recorded during the phase of no ureteral peristaltic contraction with continual instillation of sterile water via the catheter at a constant rate. By this technique, the length of functional intramural ureter (FUimL) was estimated to be 10-15 mm and the resting pressure in the intramural ureter (Pr) was between 5 and 10 mmHg in patients with possibly normal intramural ureter (4 ureters). In cases of chronic dysuria with cystographic evidence of morphologic changes in the bladder and with no vesicoureteral reflux (VUR), the FUimL was 5 mm and the Pr 2-3 mmHg. The corresponding values were 5 mm and 1 mmHg with a ureter showing VUR. The data obtained indicated that the product of these parameters, FUimL X Pr, may reflect the function of intramural ureter. The method reported herein being procedurally simple requiring no particular apparatus provides a remarkably valuable test for the evaluation of function of intramural ureter which has been virtually impracticable.