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      Role of the Calices in Urine Flow with Characterization of a Caliceopelvic Sphincter and Reflex

      American Journal of Nephrology

      S. Karger AG

      Calix, Renal pelvis, Micturition, Reflex

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          Aim: To study the role of the caliceal system in urine flow. Methods: Eight patients (6 men, 2 women; mean age 42.6 ± 7.6 years) with an upper polar renal mass (6 renal cysts; 2 hypernephromas) which did not encroach on the pelvicaliceal system were studied. After mass removal, a manometric catheter was introduced into one of the intact calices. Another catheter was introduced through the same calix, and the calix was filled with saline in increments of 0.1 ml, and the caliceal, caliceopelvic junction (CPJ), and renal pelvis pressures were recorded. The catheter was moved to the renal pelvis, and the pressure response of the aforementioned sites to renal pelvic filling with saline in increments of 1 ml was registered. The effect of filling of the locally anesthetized calix on the pelvicaliceal pressure was also determined. Results: Caliceal filling resulted in a rise of the caliceal (p < 0.01) and a drop of the CPJ (p < 0.01) pressures with no pressure response in the renal pelvis. Renal pelvic filling produced a rise of renal pelvic (p < 0.01) and CPJ (p < 0.05) pressures; the caliceal pressure showed no change (p > 0.05). Filling of the anesthetized calix or renal pelvis produced no significant pressure changes in calix, CPJ, or renal pelvis (p > 0.05). Conclusions: The CPJ dilatation upon caliceal contraction suggests a reflex relationship which we named ‘caliceopelvic inhibitory reflex’. The reflex is suggested to effect caliceal evacuation. On the other hand, CPJ closure upon renal pelvic contraction postulates another reflex relationship which we designated ‘pelvicaliceal excitatory reflex’. This reflex seems to prevent pelvicaliceal reflux. It is suggested that a ‘functional’ sphincter exists at the CPJ.

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          Most cited references 2

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          Sigmoido-rectal junction reflex: Role in the defecation mechanism

           Ahmed Shafik (1996)
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            Pelviureteral inhibitory reflex and ureteropelvic excitatory reflex: Role of the two reflexes in regulation of urine flow from the renal pelvis to the ureter

             Ahmed Shafik (1997)

              Author and article information

              Am J Nephrol
              American Journal of Nephrology
              S. Karger AG
              December 1998
              09 December 1998
              : 18
              : 6
              : 478-484
              Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt
              13391 Am J Nephrol 1998;18:478–484
              © 1998 S. Karger AG, Basel

              Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

              Page count
              Figures: 7, References: 16, Pages: 7
              Self URI (application/pdf):
              Clinical Study

              Cardiovascular Medicine, Nephrology

              Calix, Renal pelvis, Reflex, Micturition


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