Ureteric Profilometry: A Study of the Ureteric Pressure Profile in the Normal and Pathologic Ureter

The ureteric pressure profile in the normal and pathologic ureter was studied. A 3F ureteric catheter was introduced through the ureteric orifice up to the mid-renal pelvis, and was connected to a pressure transducer. The catheter was pulled down to the urinary bladder and during withdrawal the pressures in the renal pelvis, uretero-pelvic junction (UPJ), ureter, ureterovesical junction (UVJ) and urinary bladder were recorded. The normal ureteric pressure profile started with a peak rise at the UPJ followed by a drop and fluctuations representing the peristaltic waves, and ended with a peak rise at the UVJ. The strictured moderately dilated ureter showed peristaltic waves with irregular rhythm and pressure amplitude, a condition we call "ureteroarryhthmia". The hugely dilated ureter exhibited no waves, i.e. a "silent" profile. The refluxing ureter with normal caliber showed an ureteroarrhythmic pressure profile, while the dilated ureter exhibited either a ureteroarrhythmic or a silent pattern. The study could define a characteristic profilometric pattern for the normal ureter. Two pathologic patterns could be identified: ureteroarrhythmic and silent. Ureteric pressure profilometry is suggested acts as a diagnostic tool in the various pathologic conditions of the ureter.