RECOVERY PROCESS OF INJURED URETERS IN DOGS
1989 Volume 80 Issue 11 Pages 1589-1596
Details
1989 Volume 80 Issue 11 Pages 1589-1596
This paper is the 13th report in a series of studies on the application of microexplosion to medicine and biology.
The recovery process of injured ureters was investigated in the day.
The 60 ureters of 42 mongrel dogs were used. The ureter was injured with a nail, punch or surgical knife. The “pierced injury” was passed through the ureter with a nail of 1mm or 2mm in diameter, the “punch injury” was punched out in the ureter by a punecher of 1mm or 2mm in diameter and the “cut injury” was cut in the ureter 5mm or 10mm in size with a surgical knife.
The recovery process of the injured ureter was observed in each of the two ureters 3 days, 1 week, 3 weeks, 6 weeks and 12 weeks after the injury by means of IVP, for macroscopic and microscopic findings.
The results were as follows:
1) In IVP, it was observed that the 1mm pierced injury resulted in no urine leakage after 3 days, that the 2mm pierced injury and 1mm punch injury in no urine leakage after almost 1 week and that the 2mm punch injury and 5mm cut injury and 10mm cut injury in no urine leakage after almost 3 weeks. Hydroureter due to tissue edema was observed only in one ureter with a 10mm cut injury after 1 week. No ureteral stricture, hydronephrosis or hydroureter was observed in the other ureters.
2) In macroscopic findings, urine leakage was observed similarly to IVP. A urinoma existed in 2 ureters, severe adhesion in 3 ureters, and adhesion from the plevis to the bladder in 1 ureter. Adhesion was very mild in the other ureters.
3) In microscopic findings, 3 types of recovery process were encountered in the injured ureters. In the first one, the ureter recovered primarily as transitional epithelium, which changed later to the connective tissue and muscle tissue. In the second one, the ureter was supported with surrounding tissues, and then the transitional epithelium covered the injured portion. Afterwards it proliferated as connective tissue and muscle tissue. In the third one, the ureter was closed by fibrin and the proliferated connective tissue, which changed later to muscle tissue.
Nephrostomy, stent catheterization or drainage was not employed in this experiment. From these observations the ureter is thought to be recovered primarily after injury. This suggests that a minor injury during the management of endourology for the ureter and renal pelvis, including microexplosion lithotripsy, may not result in severe complication.C
