La jonction urétéro-vésicale

Abstract

The ureterovesical junction was studied by dissection and serial sections in 50 post mortem specimens. Three points are considered in this paper: the structure of the terminal ureter, the anatomical arrangement of the ureteral hiatus and the ureteral sheath. Study of the structure of the intramural segment of the ureter demonstrated on one hand, the perfect continuity of the terminal ureter with the trigone and on the other hand, the abundance of the fibroelastic connective fibers which like the muscle fibers run longitudinally. The compliance of the intravesical ureter is dependent on the balance between these two components. The modification of this balance can lead to the creation of a functional obstacle. The anatomical arrangement of the ureteral hiatus is described. The inner muscle layer of the detrusor extends almost to the ureteral orifice, the truly submucosal part of the ureter thus being very small. The constitution of the ureteral orifice and its relations to the ureter account for the different positions of juxtaureteral diverticula and transhiatal herniae of the bladder mucosa. The many descriptions of the ureteral sheath appearing in the literature are reviewed in light of the findings from the present study. The juxtavesical segment of the ureter is surrounded by a fibroconjunctive sheath which fixes the ureter to the bladder wall. The transparietal segment of the ureter is ensheathed in its adventitia, whereas a fibromuscular sheath cannot be truly individualized over this ureteral segment.

A View on the Anatomy of the Ureterovesical Junction

“…By contrast, some authors report that only a few superficial bladder muscle bundles run to the adventitia of the lower ureter (1) and act as a sort of hinge (4) or merely encircle the juxtavesical ureter (13). Our observations do not support these descriptions, nor do we agree with the concept of a predominantly (23,24,25) or exclusively (2,8,14) ureteral origin for the muscle fibers in the sheath.…”

“…The mucous membrane is known to be much more adherent to the underlying tissues in the trigonal region (3, 13,29) and this is confirmed in our specimens.…”

Action Potential of the Intramural Ureter in the Dog

“…There have been many reports starting with that of Tanagho and Pugh (8] on the anatomy and functions of the ureterovesical junction [9,10]. However, there have been no reports of clcctromyograms recorded from the intramural ureter.…”

Ultrasonographic anatomy and diagnosis of fetal uropathies affecting the upper urinary tract

“…In this case, the hydronephrotic right kidney showed abnormally higher echogenicity than the liver, a few hyperdense areas scattered throughout the parenchyma Figs. [63][64] 63 Type IV polycystic disease. This photograph taken at autopsy shows the polycystic kidneys with megaloureters and megalocystis (prune-belly syndrome) 64 Type IV polycystic disease (same case as in fig.…”

“…An increase of the connective component of the terminal part of the ureter has often been found in primary megaloureter. This structural modification causes dislocation of the muscle bundles and decreased compliance of the terminal ureter leading to reduced size of the functional lumen and ureteral dilatation proximal to the defect [64].…”