Studies in Normal Ureteral and Vesical Pressure

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Abstract
A cystoscope was inserted in the bladder, and through it No. 6 ureteral catheters were passed either into the ureters or the bladder. To the outer end of the catheters, pressure gauges (as devised at the Crowell clinic) were attached and the readings were determined in mm. of Hg. There is very little increase in the bladder pressure from the point of first feeling the desire to void, to the point of maximum distention. There is a marked increase in the pressure when the act of micturition is attempted with the bladder completely filled. In the normal distended bladder, no independent contractions of the bladder walls are noted. Measurements of intraureteral pressure showed that: (1) the pressure in the 2 ureters is not equal on both sides at the same level; (2) the intraureteral pressure increases as one approaches the bladder. A comparison was also made of the intraureteral pressure at the 10 cm. level with that occurring in the bladder under varying degrees of distention. As the bladder was filled to the maximum, the peristaltic waves in the ureter increased in rate and amplitude. The ureteral pressure was never found higher than that of the bladder filled to the maximum and with the subject straining as in voiding. The abdominal pressure plus that of the peristaltic wave is greater than the maximum bladder pressure. Observations also showed that the intra-abdominal pressure is an important factor in raising both ureteral and vesical pressure.

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