Urodynamic after-contraction waves: a large observational study in an adult female population and correlation with bladder and ureter emptying functions in women.

OBJECTIVE: To evaluate different patterns of after-contraction (A-C) waves detected during urodynamic evaluation in women. PATIENTS AND METHODS: 4,110 women were prospectively observed regarding the presence of A-C waves upon urodynamic evaluation. Intravenous pyelography and ultrasound were requested. Paired t test, χ(2) test, Wilcoxon's rank sum test and correlation analysis were performed with a 95% significance level. RESULTS: There were three distinguishing patterns of A-C: type I - detrusor contraction after the regular voiding phase, type II - detrusor contraction persisting after the flow rate had stopped, and type III - rebound of the detrusor contraction after the flow. A-C was observed in 13.9% of the women. Type I A-C wave patterns were present in 68 patients (11.8%), type II A-C wave patterns in 477 patients (83.2%), and type III A-C wave patterns in 28 patients (10.3%). Studies with intravenous pyelography and ultrasound very frequently showed bladder mucosa, muscle thickening or trabeculation. Secondary ureterectasis related to A-C waves was also observed. Additionally, watts factor, maximum flow rate, detrusor pressure and opening detrusor pressure were markedly elevated in patients with type III A-C, suggesting enhanced detrusor contraction in these A-C waves. CONCLUSION: A-C waves are a real urodynamic entity with different patterns of presentation and with clinical and morphological alterations.

Effects of potassium channel modulators cromakalim, tetraethylammonium and glibenclamide on the contractility of the isolated human ureter.

PURPOSE: Experiments were performed to assess the effect of the potassium channel modulators cromakalim, tetraethylammonium (TEA) and glibenclamide on the contractility of isolated human ureteric rings. MATERIALS AND METHODS: Segments of human distal ureter obtained from kidney donors (leftovers) were cut into rings and suspended in an organ bath filled with modified Tyrode solution for measurement of isometric contractile force. The ureter was stimulated electrically or with KCl, and the contractile activity recorded on a polygraph. RESULTS: The amplitude of the contraction induced by electrical stimulation was not changed by glibenclamide but was enhanced by tetraethylammonium. The resting tension of the ureter was not changed by either potassium channel inhibitor. Cromakalim did not change the resting tension of the human ureter per se but induced a concentration-dependent inhibition of the contractions induced by electrical stimulation. This inhibitory effect of cromakalim was not changed by tetraethylammonium but was inhibited by glibenclamide. A phasic and tonic contractile response in the isolated human ureteric ring was induced by 60 mM. KCl. The phasic contractions were abolished by cromakalim whereas the tonic contractions were unaffected. Following sustained contraction induced by 25 mM. KCl, the cumulative addition of cromakalim to the organ bath produced a concentration-dependent relaxation. However, in rings precontracted with 60 mM. KCl, cromakalim at a concentration as high as 10(-5) M. did not induce relaxation. The cromakalim-induced relaxation of rings precontracted with 25 mM. KCl was significantly inhibited by glibenclamide. CONCLUSION: These results suggest that potassium channels are important in the control of human ureter contractility and that potassium channel openers may be an alternative therapeutic indication in the treatment of human ureteric colic.

Aspectos radiológicos de la fisiopatogía ureteral / Roentgenography in ureter physiopatology

La imágen de los uréteres dilatados en la urografía se presenta con atonía, sin ondas peristálticas. La punción de la pelvis renal con aguja metálica genera potenciales que estimula la formación de ondas peristálticas en diferentes variedades. Los hallazgos encontrados se pueden enumerar como sigue: 1) Origen de las ondas peristálticas en pelvis o unión pielo-ureteral, 2) Espasmos piélicos con bloqueo de las ondas a nivel pielo-ureteral, 3) Espasmos ureterales, 4) Origen ectópico de peristaltismo y antiperistaltismo, 5) Hiperperistaltismo, 6) Dilatación fusiforme de uréteres, 7) Dilatación ureteral total, 8) Alteración del peristaltismo en fístulas ureterales. Se procura relacionar estas alteraciones en relación a aspectos microscópicos descritos por otros autores

Contribuiçäo ao estudo experimental do peristaltismo ureteral / Experimental study of ureteral peristalsis

Foi realizado um estudo sobre o peritaltismo uretral, pressäo arterial e fluxo urinário em cäes, transportando a urina da pelve renal para a bexiga, com objetivo de verificar os efeitos da enervaçäo (periférica, central e bloqueio ganglionar), a açäo das drogas adrenérgicas e medicamentos vasoativos. Concluiu-se que a enervaçäo näo alterou o peristaltismo ureteral, já as drogas adrenérgicas promoveram importantes variaçöes, similares as provocadas por medicamentos vasoativos, sugerindo que no controle do peritaltismo ureteral as mudanças no fluxo urinário säo mais importantes que os efeitos dos medicamentos empregados

Glomerulopressin activity in peripheral blood of newly diagnosed type I (insulin-dependent) diabetic patients and in normal subjects treated with glucagon.

The glomerulopressin activity of the ultrafiltrate obtained from the peripheral blood of normal subjects, newly diagnosed Type I (insulin-dependent) diabetic patients (IDD), and in normal subjects treated with glucagon was studied in two bioassays: tonic tension contraction of the rat stomach fundus (TTC) and increase in the ureteral pressure of the toad, which was considered as a glomerular pressure index (delta GPI). The ultrafiltrate of four normal volunteers had a low activity in the TTC assay, and in two subjects no activity was observed. The ultrafiltrate of five of these subjects had no activity in delta GPI. In IDD patients the ultrafiltrates were active in the TTC assay and in the toad assay. In glucagon treated normal volunteers three of the ultrafiltrates were very active in the TTC assay and other three had a low activity. In the toad assay five of them were active and no response was observed in one subject. These observations suggest that glomerulopressin activity is increased in peripheral venous blood of untreated newly diagnosed IDD patients and in normal subjects treated with glucagon.

Glomerulopressin activity in peripheral blood of newly diagnosed type I (insulin-dependent) diabetic patients and in normal subjects treated with glucagon

Se estudió en dos ensayos biológicos la actividad de glomerulopresina en sangre periférica de voluntarios normales, pacientes diabéticos Tipo I (insulino-dependientes) de reciente diagnóstico (DID), y en voluntaríos normales tratados con glucagon. Los dos bioensayos fueron: a) variación en la tensión tónica contráctil del fundus de estómago de rata (TTC), y b) aumento de la presión ureteral del sapo que es considerada como índice de la presión glomerular (delta IPG). El ultrafiltrado obtenido de cuatro voluntarios normales tuvo una pequeña actividad en el TTC, y en otros dos sujetos no se observó actividad. El ultrafiltrado de cinco de estos sujetos no tuvo actividad en el delta IPG. El ultrafiltrado de los pacientes DID fue activo en los bioensayos. En tres de los ultrafiltrados de los normales tratados con glucagon el ultrafiltrado fue muy activo en el TTC, y en otros tres sujetos tratados con glucagon el ultrafiltrado fue poco activo en el TTC. En cinco de los voluntarios tratados con glucagon el ultrafiltrado fue muy activo en el ensayo del sapo. Estas observaciones sugieren que la actividad de glomerulopresina está aumentada en la sangre periférica de los pacientes DID de reciente diagnóstico y en sujetos normales tratados con glucagon (AU)

Glomerulopressin activity in peripheral blood of newly diagnosed type I (insulin-dependent) diabetic patients and in normal subjects treated with glucagon

Se estudió en dos ensayos biológicos la actividad de glomerulopresina en sangre periférica de voluntarios normales, pacientes diabéticos Tipo I (insulino-dependientes) de reciente diagnóstico (DID), y en voluntaríos normales tratados con glucagon. Los dos bioensayos fueron: a) variación en la tensión tónica contráctil del fundus de estómago de rata (TTC), y b) aumento de la presión ureteral del sapo que es considerada como índice de la presión glomerular (delta IPG). El ultrafiltrado obtenido de cuatro voluntarios normales tuvo una pequeña actividad en el TTC, y en otros dos sujetos no se observó actividad. El ultrafiltrado de cinco de estos sujetos no tuvo actividad en el delta IPG. El ultrafiltrado de los pacientes DID fue activo en los bioensayos. En tres de los ultrafiltrados de los normales tratados con glucagon el ultrafiltrado fue muy activo en el TTC, y en otros tres sujetos tratados con glucagon el ultrafiltrado fue poco activo en el TTC. En cinco de los voluntarios tratados con glucagon el ultrafiltrado fue muy activo en el ensayo del sapo. Estas observaciones sugieren que la actividad de glomerulopresina está aumentada en la sangre periférica de los pacientes DID de reciente diagnóstico y en sujetos normales tratados con glucagon