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Urodynamics of the upper urinary tract

C E Constantinou, J R Hrynczuk

    Investigative Urology
    |November 1, 1976
    PubMed
    Summary

    The ureteral pacemaker system maintains a constant frequency during varying urine flow rates. Ureteral contractions adapt by increasing bolus volume to accommodate diuresis.

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    Area of Science:

    • Urology
    • Physiology

    Background:

    • Ureteral peristalsis is crucial for urine transport.
    • The role of the ureteral pacemaker system in regulating contractions under varying urine flow is not fully understood.

    Purpose of the Study:

    • To investigate the influence of pacemaker frequency on ureteral contractions and bolus volume.
    • To determine how the ureteral pacemaker system responds to changes in urine flow rate during diuresis.

    Main Methods:

    • Experimental observations on anesthetized dogs.
    • Measurement of renal pelvis pressure waves to determine pacemaker frequency.
    • Electrophysiological recording of ureteral peristaltic rate.
    • Drop counter utilization to measure bolus volume.

    Main Results:

    • Pacemaker frequency remained constant across urine flow rates from 0.3 to 15 ml/min.
    • Pacemaker frequency was stable during significant transient increases in urine flow.
    • During diuresis, ureteral peristaltic rate adjusted in quantum steps dictated by the pacemaker frequency.
    • At flow rates >2 ml/min, ureteral contractions occurred at the pacemaker rate, with increased bolus volume accommodating higher flow.

    Conclusions:

    • The ureteral pacemaker system exhibits remarkable stability in frequency despite significant variations in urine flow.
    • Ureteral adaptation to diuresis involves coordinated changes in contraction rate and bolus volume, regulated by the pacemaker.
    • These findings have implications for understanding upper urinary tract function in conditions like unicalyceal and multicalyceal systems.

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