The necessity for preserving the normal peristaltic activity of the ureter and thereby maintaining an undisputed right of way for the passage of the urine from the kidneys to the bladder has been accepted as an incontrovertible fact.
In his splendid publications on the physiology of the ureter, Trottner1 has pointed out that this structure can be conveniently separated into three divisions—upper, middle and lower thirds. This division is based on the results of his physiologic and pharmacologic studies. Progressive peristalsis may commence in any of these divisions; eventually, the peristaltic activity will spread throughout the remainder of the ureter. If the ureter is unable to convey its contents to the bladder and this adynamic status prevails relatively long, then renal damage is an inevitable consequence. Such incidental accessory factors as gravity, descent of the diaphragm and transmitted renal filtration pressure are capable of aiding in the passage of
GETZOFF PL, TOMSKEY GC, OGDEN HD. TREATMENT OF URETERAL SPASM: OBSERVATIONS WITH SPECIAL REFERENCE TO THE USE OF EXTRACT OF MAMMALIAN SKELETAL MUSCLE. Arch Surg. 1942;44(2):370–377. doi:10.1001/archsurg.1942.01210200186013
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