방광요관 역류에서 말단 요관의 역할규명에 관한 조직학적 연구

Abstract

The normal function of the ureterovesical junction was fundamental to prevent vesicouretera1 reflux but the role of ureter in preventing vesicoureteral reflux has not been defined. To clarify the role of ureter in vesicoureteral reflux, a total 34 reimplanted juxta-vesical ureters from 22 patients were examined by light microscope, polarized microscope and computerized image analyzer. As the degree of reflux was increasing, the amount of ureteral muscle did not change significantly but that of ureteral collagen increased significantly In 6 patients with bilateral vesicoureteral reflux, which were different in grade each other, the amount of ureteral muscle and collagen were not different significantly between the lower grade and the higher grade. The amount of ureteral muscle tended to increase with grade of reflux in the dilated terminal ureters in excretory urography but not in the non-dilated. Inflammatory cell infiltration to ureteral wall gave no effect to the contents of ureteral muscle and collagen. It was suggested that the content of ureteral muscle decreased and the content of ureteral collagen increased with degree of reflux and the dilation of terminal ureter with muscle hypertrophy was a compensatory response to the increased workload.