Objective To study the fiber architecture and distribution of smooth muscle in each segment of the ureter and provide morphological basis for the treatment of ureteral stones.Methods Thirty fresh adult ureters were fixed by formalin with tissue sections to observe the morphology and distribution pattern of smooth muscle of the ureter under optical microscope The thickness and inner diameter of ureter smooth muscle by micrometer were measured. Results The smooth muscle at the beginning of the ureter was divided into four layers, and the maximum thickness of the smooth muscle was 1.59 mm on the left and 1.51 mm on the right. The maximum diameter on the left was 2.22 mm and 2.05 mm on the right. The abdominal smooth muscle was divided into three layers, and the left maximum thickness was 1.49 mm and 1.69 mm on the right. The smooth muscle in the ureter at the entrance of the small pelvis was divided into three layers, most of which were longitudinal muscle,the maximum thickness of smooth muscle on the left side was 2.38 mm, 1.98 mm on the right side. The inner diameter of the ureter was 2.11 mm on the left and 2.28 mm on the right. The ureter in the pelvic segment has four layers of smooth muscle, mostly longitudinal muscle and annular muscle, the maximum thickness of smooth muscle was 1.69 mm on the left and 1.58mm on the right.The smooth muscle of the inner wall segment was divided into three layers, the smooth muscle was the thickest, the maximum thickness on the left was 3.18mm and 3.21 mm on the right. The longitudinal muscle was the most developed, and the annular muscle was associated with the urethral sphincter. The ureteral inner diameter was 1.25 mm on the left and 1.70 mm on the right. The interrelationship between ureteral smooth muscle construction and urodynamics was discussed. Conclusions The main reason for the difficulty in the reduction of ureteral calculi may be related to the arrangement of longitudinal muscle and circular muscle of ureteral smooth muscle.
Key words
Ureter;  /
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Smooth muscle construction;  /
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Urodynamics;  /
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Ureteral stone
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References
[1] Scales CDJr, Tasian GE,Schwaderer AL, et al. Urinary stone discrse: advancing knowledge,patient care, and population health [J]. Clin J Am Soc Nephrol, 2016, 11(7):1305-1312. DOI: 10.2215/CJN. 13251215.
[2] 安瑞, 赵玉宝.输尿管镜钬激光碎石术和体外冲击波碎石术在治疗输尿管上段结石的比较分析[J]. 中国药物与临床, 2017, 17(7):1052-1054. DOI: 10.11655/zgywylc2017.07.048.
[3] 孙伟, 程庆水. α1肾上腺素能受体阻滞剂在输尿管下段结石治疗中的应用进展[J].沈阳医学院学报, 2017, 19(2):159-162. DOI: 10.16753/j.cnki.1008-2344.2017.02.027.
[4] 罗春风.输尿管镜下气压弹道碎石术与体外冲击波碎石术治疗输尿管儿结石的疗效对比[J]. 临床医学研究与实践, 2017, 2(1):53-54. DOI: 10.19347/j.cnki.2096-1413.201701027.
[5] 叶烈夫, 傅长德, 杨泽松, 等.坦索罗辛对肾结石体外震波碎石术后辅助排石作用的研究[J].中华临床医师杂志, 2013, 7(6):2433-2437. DOI: CNKI:SUN:ZLYD.0.2013-06-039.
[6] Erturhan S, Erbagci A, Yagci F, et al. Comparative evaluation of efficacy of use of tamsulosin and/or tolterodine for medical treatment of distal ureteral stones [J]. Urology, 2007, 69(4):633-636. DOI: 10.1016/j.urology.2007.01.009.
[7] Sigala S, Dellabella M, Milanese G, et al. Evidence for the presence of alpha1 adrenoceptor subtypes in the human ureter [J]. Neurourol Urodyn, 2005, 24(2):142-148. DOI: 10.1002/nau.20097.
[8] 单海涛,徐乐,李俊葵, 等. 芍药甘草汤加金钱草对新西兰兔离体输尿管平滑肌张力的影响[J]. 中医药临床杂志, 2015, 27(2):238-241. DOI: CNKI:SUN:AHLC.0.2015-02-036.
[9] 陈邦盛, 余小玲, 刘洁泉, 等.输尿管结石崁顿部位与临床特征的相关性分析[J]. 广东医学, 2020,(3):265-268.
[10] 张源亮, 李克赞, 吕伯实, 等.输尿管的观测及其临床意义[J]. 临床解剖学杂志, 1987, 5(2):107-108. DOI:10.13418/j.issn.1001-165x. 1987. 02.024.
[11] 覃能武, 纪瑞成.输尿管的管径与结石部位的关系[J]. 临床解剖学杂志,1986, 4(2):108-110. DOI: 10.13418/j.issn.1001-165x.1986.02.023.
[12] 金锡御, 宋波. 临床尿动力学[M]. 北京: 人民卫生出版社, 2002:40.
[13] 李伟, 梁建波. 盐酸坦洛新缓释胶囊治疗输尿管结石并前列腺增生的疗效观察 [J]. 实用医学杂志, 2010, 26(20):3798-3799. DOI: 10.3969/j.issn.1006-5725.2010.20.063.
[14] Yilmaz E, Batislam E, Basar MM, et al. The comparison and efficacy of 3 different alpha1 adrenergic blockers for distal ureteral stones [J]. J Urol, 2005, 173(2):2010-2012. DOI: 10.1097/01.ju.0000158453.60029.0a.
[15] 杨远望, 覃家雅, 林建彬, 等. 双氯芬酸钠联合坦索罗辛、结石通治疗输尿管结石合并肾绞痛疗效分析[J]. 中国现代医药杂志, 2019, 2(3):18-23.DOI: CNKI:SUN:ZHTY.0.2019-03-005.
[16] 陈卫红,刘军,王元林, 等.52例a1受体阻滞剂在输尿管上段结石体外冲击波碎石术后的应用[J]. 重庆医学, 2012, 41(1):40-41,43.DOI:10.3969/j.issn.1671-8348.2012.01.015.
[17] 张超民. 输尿管结石治疗进展与现状[J]. 临床医药文献电子杂志,2020, 7(37):193-194. DOI: 10.16281/j.cnki.jocml.2020.37.163.