Experimental Local Bladder Edema Causing Urine Reflux Into Ureters and Kidneys

Abstract

There are no experimental studies recorded, as far as we are aware, of the role that a local transitory edema of the ureteral valve plays in the ureteral reflux of urine. Such a local edema we produced by infiltrating the vesical site of the ureter with 25% magnesium sulphate or with physiological salt solution.

We used 14 guinea pigs, 21 rabbits and 17 dogs, narcotized by morphine, or sodium barbital with or without magnesium sulphate, or ether. In dogs, ether only was used. The bladder and ureters were exposed through a median incision; pressure was recorded through a flanged cannula inserted in the bladder apex, and a water or mercury manometer. India ink was injected into the bladder as indicator. A few times the urethra was ligated. Infiltration of the ureter in its vesical course was done through a fine hypo needle; the amount varied between 0.2 and 2.0 cc.

In 14 guinea pigs (9♀,5♂) 10 showed regurgitation (3♀, 7♂). The pressures ranged between 50 and 280 mm. water (4 to 21 mm. Hg.). In 4 non-pregnant females, spontaneous reflux occurred into both ureters without infiltration under pressures between 20 and 120 mm. water (2 to 9 mm. H.g.).

In 21 rabbits (12♀, 9♂) 19 showed reflux into one or both ureters. The bladder pressures after infiltration ranged between 30 and 120 mm. water (3- to 9 mm. Hg.). The average control pressure giving no reflux before infiltration was 110 mm. water (9 mm. Hg.).

Spontaneous reflux without infiltration was seen in 2 non-pregnant females, one pregnant female and in one male. In the male and in one non-pregnant female biopsy revealed edematous ureteral orifices and a congested bladder mucosa.

In 17 dogs (8♀. 9♂) ureteral reflux was observed in 13 (6♀, 7♂); no reflus was obtained in 2 males and 2 pregnant females. The bladder pressures necessary for reflux after infiltration varied between 3 and 12 mm. Hg. The average control pressure tested with negative results before infiltration was 8 to 40 mm. Hg. Spontaneous regurgitation without infiltration was seen in 2 females, one of them in early pregnancy.