Notes on the surgical physiology of the dog

Abstract

In a previous communication 3 the possible causal relationship of a paralyzed ureter to dilatations of the ureter and kidney pelvis has been pointed out. Of the experiments performed in 1913, 75 per cent, showed hydronephrosis in some degree. Last fall the same technic was repeated in twelve dogs with the following results:

2 Negative.

6 Hydronephrosis—to some degree.

1 Hydroureter.

3 Dilatation of cephalad ureter.

Therefore fifty per cent, showed hydronephrotic change and eighty-three and one-third per cent, hydronephrotic and hydroureteric changes combined.

It was realized in applying this information to the origination of a physiological uretero-sigmoid union, some traumatization of the transposed ureter and therefore some impairment of ureteric function was absolutely unavoidable. But making allowance for this reduced prostaltic power by the least possible total ureteral traumatization and by purposely confining the necessary handling to the negligible caudad third, an effort has been made to balance such impaired power by a physiologic load. To this end twenty dogs have been operated upon by transplanting one ureter in seven and both ureters in thirteen dogs. The results were as follows:

I. Direct uretero-sigmoidal entrance was found more obstructive than the oblique entrance.

2. When ureteral dilatation occurred it appeared first in the cephalad third of the ureter. This was associated in the animals having greater caudad obstruction with dilatation of the second or second and caudad thirds of the ureter and renal pelvis.

3. Each of the seven dogs with singly transplanted ureters showed hydronephrosis in some degree. The ureter in each case had been made to enter the sigmoid directly or obliquely for not over 0.5 cm.

4. Of the thirteen with doubly transplanted ureters, three showed cephalad ureteral dilatation only. These were dogs in which the ureters traversed the sigmoidal wall for 1.5 cm.