Evaluation of Distal Ureter Peristalsis by Multichannel Impedance Monitoring in Patients with Renal and Ureteral Stones

摘要

Distal ureter peristalsis was evaluated during uret-eroscopic examination by means of multichannel impedance ureterography in 30 patients with renal and ureteral stones and in 3 patients with normal ureters. The documented data included the number of ureteric contractility parameters such as peristalsis amplitude, peristalsis rate, ureteral wall tone, duration and velocity of contractions, characteristics of contractile waveforms and their direction (antegrade, cystoid, or retrograde). Peristalsis amplitude tended to decrease while ureteral wall tone had a tendency to increase in patients with stones compared to normal ureters, although both parameters markedly differed in individual patients. As a rule, peristalsis was more disturbed at stone location. More cases of aberrant peristalsis were found in distal (54%) or proximal (45%) ureters with stones compared to the cases with stones in kidney (10%). The retrograde contractile waves were frequently observed in patients with renal (50%), proximal (56%) and distal (25%) ureteral stones. The antegrade peristaltic waves remained in 50% ureters with proximal stones and only in 12% ureters with distal stones. The multichannel impedance ureterography can be employed as a reliable method to study contractile function of a ureter. It may be useful for proper treatment modality choice in patients with urodynamic disorders.