Wan Long,Li Manyuan,Wu Wenbo.Biomechanical finite element analysis of ureteral tunnel during ureteral bladder replantation[J].Journal of Clinical Pediatric Surgery,,():1186-1190.[doi:10.3760/cma.j.cn101785-202405014-014]
Biomechanical finite element analysis of ureteral tunnel during ureteral bladder replantation
- Keywords:
- Vesico-Ureteral Reflux; Replantation; Ureter; Finite Element Analysis
- Abstract:
- Objective To explore the biomechanical effect of ureteral submucosal tunnel during ureteral reimplantation. Methods Different vesicoureteral models were established with ANSYS 2020 R2 software.Finite element analysis (FEA) of biomechanics during storage and urination periods was conducted for evaluating the stress and strain distribution of vesicoureteral junction under different models. Results Simulation results indicated that during urine storage period,maximal equivalent stress of A1/A3 type tunnel sections was 1% and 3% higher than that of A2 type tunnel sections; During urination period,maximal equivalent stress of A1/A3 type tunnel segments was 9% and 12% higher than that of A2 type and the difference was insignificant.When compared with type A2,storage and urination periods of type B decreased by 46% and 53% respectively. Conclusions Ureteral submucosal tunnel is essential for ureteral reimplantation.However,changing its length appropriately has no significant effect on biomechanics.
References:
[1] Hutch JA,Ayres RD,Loquvam GS.The bladder musculature with special reference to the ureterovesical junc-tion[J].Trans West Sect Am Urol Assoc,1960,27:83-93.DOI:10.1016/S0022-5347(17)65374-6.
[2] Tullus K.Vesicoureteric reflux in children[J].Lancet,2015,385(9965):371-379.DOI:10.1016/S0140-6736(14)60383-4.
[3] 中华医学会小儿外科学分会泌尿外科学组.儿童原发性膀胱输尿管反流专家共识[J].临床小儿外科杂志,2019,18(10):811-816.DOI:10.3969/j.issn.1671-6353.2019.10.002. Pediatric Urology Group,Branch of Pediatric Surgery,Chinese Medical Association.Expert consensus on management of primary vesicoureteral reflux in children[J].DOI:10.3969/j.issn.1671-6353.2019.10.002.
[4] Wein AJ,Kavoussi LR,Partin AW,等.坎贝尔-沃尔什泌尿外科学-第7卷-小儿泌尿外科学[M].夏术阶,纪志刚,杨屹,等译.第11版.郑州:河南科学技术出版社,2020:430-432. Wein AJ,Kavoussi LR,Partin AW,et al.Campbell-Walsh urology-volume 7-pediatric urology[M].Xia SJ,Ji ZG,Yang Y,et al,translated.11th ed.Zhengzhou:Henan Science and Technology Press,2020:430-432.
[5] 王芳,孔虎,翟丽东,等.男性尿道括约肌失协同的有限元分析[J].医用生物力学,2022,37(1):131-136.DOI:10.16156/j.1004-7220.2022.01.020. Wang F,Kong H,Zhai LD,et al.Finite element analysis of male urethral sphincter loss synergy[J].J Med Bio-mech,2022,37(1):131-136.DOI:10.16156/j.1004-7220.2022.01.020.
[6] Wyndaele JJ.Normality in urodynamics studied in healthy adults[J].J Urol,1999,161(3):899-902.
[7] Tekgül S,Riedmiller H,Hoebeke P,et al.EAU guidelines on vesicoureteral reflux in children[J].Eur Urol,2012,62(3):534-542.DOI:10.1016/j.eururo.2012.05.059.
[8] Stein R,Dogan HS,Hoebeke P,et al.Urinary tract infections in children:EAU/ESPU guidelines[J].Eur Urol,2015,67(3):546-558.DOI:10.1016/j.eururo.2014.11.007.
[9] Diamond DA,Mattoo TK.Endoscopic treatment of primary vesicoureteral reflux[J].N Engl J Med,2012,366(13):1218-1226.DOI:10.1056/NEJMct1108922.
[10] Chertin B,Puri P.Endoscopic management of vesicoureteral reflux:does it stand the test of time?[J].Eur Urol,2002,42(6):598-606.DOI:10.1016/s0302-2838(02)00447-5.
[11] Kim KW,Park SH,Im G,et al.CFD study on vesicoureteral reflux in the urinary tract with double J stent[J].Comput Biol Med,2022,145:105456.DOI:10.1016/j.compbiomed.2022.105456.
[12] Villanueva CA,Tong J,Nelson C,et al.Ureteral tunnel length ver-sus ureteral orifice configuration in the deter-mination of ureterovesical junction competence:a computer simulation model[J].J Pediatr Urol,2018,14(3):258.e1-258.e6.DOI:10.1016/j.jpurol.2018.01.009.
[13] Kalayeh K,Brian Fowlkes J,Schultz WW,et al.The 5:1 rule overestimates the needed tunnel length during ure-teral reimplantation[J].Neurourol Urodyn,2021,40(1):85-94.DOI:10.1002/nau.24526.
Memo
收稿日期:2024-5-7。
通讯作者:吴文波,Email:1650960176@qq.com