The considerations set forth in this article make it possible to define the physionomy of the transplanted ureter in the following way: morphologically, in the optimal cases, it approaches that encountered in normal uretero-cystoneostomies, although being somewhat less good. From the functional point of view the tone and the peristalsis, or the kinetics as a whole, show in the great majority of cases a certain deficiency in comparison with traditional ureterocystoneostomies and still more in comparison with the normal ureter. These features were more easily understood on checking the two types of anastomosis against each other. Descending to details, what seemed to the authors to be almost constant, especially in the preanastomotic tract, was the presence of fascicular movements that were sometimes observed, although with less frequency, in the pyelo-ureteral junction. Moreover, relatively frequently there was noted a hypotonus of the last tract of the preanastomotic ureter not connected with some deficiency of canalization. There was almost always an adaptation of the duct to its new situation after a period of time that varied from 1 to 3 months, provided that no new elements intervened. The anatomical and functional factors that determine this situation are the following. The myogenic situation of the duct remains almost unchanged and here the importance of pacemakers in the genesis of peristalsis must be recorded. The supporting tissue does not undergo any considerable changes; nevertheless, there was observed histologically a fragmentation of the elastic fibres, that was above all obvious in the preanastomotic site (surgical trauma?). The nervous system underwent those defects that have been recorded by the authors previously. From the functional aspect it can only be said that the situation in fact depends to a great degree on the anatomical condition. This characteristic situation of the transplanted ureter may be changed for the worse by the following factors: incorrect collection of the ureter to be transplanted, faulty surgical technique, episodes of rejection, and infections.
|Translated title of the contribution||Physiopathology of the transplanted ureter|
|Number of pages||32|
|Publication status||Published - 1979|
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