Urodynamics. Hydrodynamics of the Ureter and Renal Pelvis PDF
Preview Urodynamics. Hydrodynamics of the Ureter and Renal Pelvis
Contributors RICHARD ABSHER FRANK HINMAN, JR. KENJI ΑΙΤΟ TIN-KAN HUNG GORDON F. ANDERSON M. Y. JAFFRIN DONALD W. BAKER PEREGRINA C. LABAY LLOYD BARR WYLAND F. LEADBETTER WILLIAM F. BARRY, JR. PAUL S. LYKOUDIS JOHN A. BENJAMIN JOSEPH M. MALIN, JR. SAUL BOYARSKY RICHARD L. MALVIN WILLIAM H. BOYCE W. F. MELICK E. M. BRIGGS FREDERICK H. MEYERS GEORGE BUGLIARELLO PABLO A. MORALES C. E. CONSTANTINOU SIMON OSTRACH R. L. DALE JAMES M. PIERCE, JR. DAVID M. DAVIS A. H. SHAPIRO O. DUARTE-ESCALANTE ARTHUR M. STERLING CHRISTOPHER M. FREDERICKS EMIL A. TANAGHO YUAN-CHENG B. FUNG ERIC E. THERKELSEN J. F. GLENN S. L. WEINBERG WILLARD E. GOODWIN ROBERT M. WEISS CARL W. GOTTSCHALK J. J. WORTMAN D. E. GOVAN PAUL D. ZIMSKIND JAY H. HARRIS NORMAN R. ZINNER URODYNAMICS Hydrodynamics of the Ureter and Renal Pelvis Saul Boyarsky Carl W. Gottschalk Division of Genitourinary Surgery Department of Medicine and Physiology Department of Surgery University of North Carolina Washington University School of Medicine Chapel Hill, North Carolina St. Louis, Missouri Emil A. Tanagho Paul D. Zimskind Division of Urology Department of Urology University of California School of Medicine Jefferson Medical College San Francisco, California Philadelphia, Pennsylvania Planning and conduct of Workshop and preparation of the proceedings for publication were supported by the Offices of the Surgeon General of the Department of the Army, the Department of the Navy, and the Department of the Air Force, Contract DADA17- 69-C-9084; the Division of Research Grants, National Institutes of Health Contract PH43-64-44, Task Order No. 3; and the National Institute of Arthritis and Metabolic Diseases Contract NIH-69-797. ACADEMIC PRESS New York and London 1971 COPYRIGHT © 1971, BY ACADEMIC PRESS, INC. ALL RIGHTS RESERVED NO PART OF THIS BOOK MAY BE REPRODUCED IN ANY FORM, BY PHOTOSTAT, MICROFILM, RETRIEVAL SYSTEM, OR ANY OTHER MEANS, WITHOUT WRITTEN PERMISSION FROM THE PUBLISHERS. RIGHTS FOR PRIVILEGED USE BY THE UNITED STATES GOVERNMENT FOR SPECIAL PURPOSES ARE RESERVED. ACADEMIC PRESS, INC. Ill Fifth Avenue, New York, New York 10003 United Kingdom Edition published by ACADEMIC PRESS, INC. (LONDON) LTD. Berkeley Square House, London W1X 6BA LIBRARY OF CONGRESS CATALOG CARD NUMBER: 70-170123 PRINTED IN THE UNITED STATES OF AMERICA List of Contributors Numbers in parentheses indicate the pages on which the authors' contributions begin. RICHARD ABSHER (233, 399, 473), Department of Electrical Engi- neering, University of Vermont, Burlington, Vermont KENJI AITO (497), Urological Department, Matsuyama Sekijuji Hos- pital, Matsuyama, Ehenie-Ken, Skikoku, Japan GORDON F. ANDERSON (283), Department of Physiology and Pharma- cology and Department of Urology, Wayne State University School of Medicine, Detroit, Michigan DONALD W. BAKER (425), Bioengineering Program, University of Washington, Seattle, Washington LLOYD BARR (49), Department of Physiology and Biophysics, Woman's Medical College of Pennsylvania, Philadelphia, Pennsylvania WILLIAM F. BARRY, JR. (133, 399), Department of Radiology, Duke University Medical Center, Durham, North Carolina JOHN A. BENJAMIN (77), Division of Urology, Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York SAUL BOYARSKY (55, 99, 163, 317, 349, 399, 473, 497, 571), Division of Genitourinary Surgery, Department of Surgery, Washington Uni- versity School of Medicine, St. Louis, Missouri WILLIAM H. BOYCE (513), Division of Urology, Department of Surgery, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina xvii xviii LIST OF CONTRIBUTORS E. M. BRIGGS (143, 455), Division of Urology, Department of Surgery, Stanford University School of Medicine, Stanford, California GEORGE BUGLIARELLO (485), University of Illinois at Chicago Circle, Chicago, Illinois C. E. CONSTANTINOU (143, 455), Division of Urology, Department of Surgery, Stanford University School of Medicine, Stanford, California R. L. DALE (143, 455), Division of Urology, Department of Surgery, Stanford University School of Medicine, Stanford, California DAVID M. DAVIS (363), Department of Urology, Jefferson Medical College, Philadelphia, Pennsylvania 0. DUARTE-ESCALANTE (29, 317), Division of Genitourinary Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri CHRISTOPHER M. FREDERICKS (283), Department of Physiology and Pharmacology and Department of Urology, Wayne State Uni- versity School of Medicine, Detroit, Michigan YUAN-CHENG B. FUNG (177), Department of Engineering Science (Bioengineering), University of California at San Diego, La Jolla, California J. F. GLENN (497), Division of Urology, Duke University Medical Center, Durham, North Carolina WILLARD E. GOODWIN (507), Division of Urology, Department of Surgery, University of California Medical School and Wadsworth Veterans Administration Hospital Los Angeles, California, and Los Angeles County Harbor General Hospital, Torrance, California CARL W. GOTTSCHALK (299, 571), Department of Medicine and Physiology, University of North Carolina, Chapel Hill, North Carolina D. E. GO VAN (143, 455), Division of Urology, Department of Surgery, Stanford University School of Medicine, Stanford, California JAY H. HARRIS (465), Department of Electrical Engineering, and Uro- dynamics Laboratory, Department of Urology, University of Wash- ington, Seattle, Washington FRANK HINMAN, JR. (353), Division of Urology, University of Cali- fornia School of Medicine, San Francisco, California LIST OF CONTRIBUTORS xix TIN-KAN HUNG (485), Biotechnology Committee, Carnegie-Mellon University, Pittsburgh, Pennsylvania M. Y. JAFFRIN (217), Department of Mechanical Engineering, Massa- chusetts Institute of Technology, Cambridge, Massachusetts PEREGINA C. LABAY (55, 99, 163, 317, 349, 497), Division of Genito- urinary Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri WYLAND F. LEADBETTER (503), The Massachusetts General Hos- pital, Harvard Medical School, Boston, Massachusetts PAUL S. LYKOUDIS (199), School of Aeronautics, Astronautics, and Engineering Sciences, Purdue University, West Lafayette, Indiana JOSEPH M. MALIN, JR. (125), Department of Urology, Wayne State University School of Medicine, Detroit, Michigan RICHARD L. MALVIN (309), Department of Physiology, University of Michigan, Ann Arbor, Michigan W. F. MELICK (493), Division of Urology, Department of Surgery, St. Louis University School of Medicine, St. Louis, Missouri FREDERICK H. MEYERS (119, 255, 479), Department of Pharma- cology, University of California School of Medicine, San Francisco, California PABLO A. MORALES (87), Department of Urology, New York Univer- sity Medical Center, New York, New York SIMON OSTRACH (167), Division of Fluid, Thermal, and Aerospace Sciences, Case Western Reserve University, Cleveland, Ohio JAMES M. PIERCE, JR. (283), Department of Physiology and Pharma- cology and Department of Urology, Wayne State University School of Medicine, Detroit, Michigan A. H. SHAPIRO (217), Department of Mechanical Engineering, Massa- chusetts Institute of Technology, Cambridge, Massachusetts ARTHUR M. STERLING (411), Urodynamics Laboratory, Department of Urology, University of Washington, Seattle, Washington EMIL A. TANAGHO (3, 119, 255, 479, 571), Division of Urology, Uni- versity of California School of Medicine, San Francisco, California XX LIST OF CONTRIBUTORS ERIC E. THERKELSEN (465), Department of Electrical Engineering, and Urodynamics Laboratory, Department of Urology, University of Washington, Seattle, Washington S. L. WEINBERG* (217), Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts ROBERT M. WEISS (261), Section of Urology, Yale University School of Medicine, New Haven, Connecticut, and Department of Pharmacology, Columbia University, College of Physicians and Sur- geons, New York, New York J. J. WORTMAN (473), Research Triangle Institute, Research Triangle Park, North Carolina PAUL D. ZIMSKIND (61, 293, 339, 509, 571), Department of Urology, Jefferson Medical College, Philadelphia, Pennsylvania NORMAN R. ZINNER (411, 465), Urodynamics Laboratory, Depart- ment of Urology, University of Washington, Seattle, Washington ♦Present address: Washington University, St. Louis, Missouri. Preface This volume summarizes the present status of urodynamics in pro- gression from the known, to the untried, to the seemingly impossible. Too many precedents exist, notably in the cardiovascular system, for us to doubt that a bioengineering analysis of urinary physiology can be equally productive. This volume spans nearly five decades in the development of urodynamics, and includes as contributors such pioneers in ureteral physiology as Davis, Lapides, Benjamin, and Morales with the more advanced urodynamicists from the engineering community. This book is an outgrowth of the proceedings and conclusions of an interdisciplinary workshop devoted to the hydrodynamics of the ureter and renal pelvis, a companion second workshop to one which dealt with the hydrodynamics of micturition, both sponsored by The National Re- search Council and National Academy of Sciences, Division of Medical Sciences, Committee on The Genitourinary System. Such workshops have introduced new concepts, new methodologies, and insights, and have dis- solved language barriers in a very successful manner. The workshop made it possible for representatives of some 30 active laboratories to meet. A continuum of discussion developed between the theoretical bioengineer, the research bioengineer, the research physiologist, the research surgeon, and the clinical urologist. Acknowledgments are due to the members of the Committee of the Genitourinary System of the National Research Council, particularly to the Chairman and guiding light, Dr. William Boyce; also to Drs. Flocks, Glenn, Goodwin, Hinman, Kass, Lattimer, Leadbetter, Schlegel, Merrill, Del Regato, and Colonel Derby, Captain Hubbard, Colonel Lewis, Dr. Edwin Coyl and his staff, including Mrs. Jean Perrin, and to Mr. Harry Weil of the Center for Continuing Education of the University of Chicago. Saul Boyarsky Carl W. Gottschalk Emil A. Tanagho Paul D. Zimskind xxi 1 Ureteral Embryology, Developmental Anatomy, and Myology EMIL A. TANAGHO DIVISION OF UROLOGY UNIVERSITY OF CALIFORNIA SCHOOL OF MEDICINE SAN FRANCISCO, CALIFORNIA The ureter starts its development as an outgrowth of the mesonephric duct at the end of the fourth week (5 mm stage) of embryonic life (Fig. 1). Close to its caudal end, where it bends before opening into the cloaca, the mesonephric duct develops a localized thickening with cell proliferation around its circumference. An outpouching on the dorsomedial aspect of this cellular proliferation indicates the first appearance of the ureteral bud. The outpouching then grows cranially to meet and unite with the metanephric cap (Fig. 2). The time of this meeting and union is important, as it determines future nephric development and ascent. Changes occur simultaneously at both ends of the ureteral bud. As a result of the progressive shortening of the common nephric duct due to its absorption into the ventral segment of the cloaca, the caudal end of the ureteral bud gradually approaches the urogenital sinus (the urethrovesical anläge differentiating from the cloaca). Finally (seventh week, 14 mm stage), the ureteral bud achieves an independent opening into the uro- genital sinus (Fig. 2). The accumulated absorbed tissue of the mesonephric duct expands and forms the trigone, maintaining direct continuity with the ureter exactly as the common nephric duct is continuous with the ureteral bud originally. If more than one ureteral bud develops, the accessory is higher on the nephric duct and meets the urogenital sinus later than the original bud. It drains the upper pole, and its vesical opening is always lower than and medial to the original one. If the original and the accessory ureteral buds 3 4 EMIL A. TANAGHO Fig. 1. Ureteral development from the mesonephric duct, demonstrating caudal and cranial migration and its relation to the pronephros and mesonephros. Fig. 2. Division of the cloaca and the progressive absorption of the mesonephric duct into the urogenital sinus. This absorbed mesodermal tissue will form the trigone, and the ureteral bud and mesonephric duct will have separate orifices.
The list of books you might like
