The Effect of Ureteral Anastomosis Upon Conduction of Peristaltic Waves: An Electro-Ureterographic Study

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Abstract
The study of canine ureteral peristalsis by electro-ureterography was performed at intervals after midureteral transection and anastomosis in order to delineate the physiologic abnormalities associated with postanastomotic hydroureter and hydronephrosis. Conduction of peristalsis through the anastomosis did not occur until 4 weeks postoperatively. With the return of anasto-motic conduction, the velocities of the peristaltic waves were slower in the ureter above the anastomosis than below it when a significant dilatation was present in the upper ureter. The degrees of ureteropelvic dilatation correlated roughly with the differences in velocities of the peristaltic waves above and below the anastomoses. The conduction of peristaltic waves through an anastomosis was always delayed at it when proximal ureteral dilatation was present. The longer the average anastomotic delay of wave conduction, the greater the ureteropelvic dilatation, and the greater the number of peristaltic waves not conducting across the anastomotic line. The duration of delay of wave conduction at the anastomosis correlated inversely with the interperistaltic wave interval. The longer the duration of conduction-delay at the anastomosis the greater the anastomotic fibrosis. Significant anastomotic stenosis was absent in all ureters studied except for the one exhibiting the greatest ureteropelvic dilatation. It is concluded that postanastomotic hydronephrosis may be caused by a functional defect in the peristaltic conduction mechanism at the anastomosis.

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