Ureteric jet in the anaesthetised child

We have already suggested that there is an active bimodal sphincteric mechanism in the human vesicoureteral junction (VUJ). This mechanism is affected by immaturity, hormonal effects and surgical ablation. This study set out to investigate the effects of anaesthesia on this mechanism. A total of 16 children undergoing surgery were recruited. They were well hydrated. The ureteric jets before and after anaesthesia were recorded using the colour and pulse wave Doppler. Of the total, 14 children showed mature (complex pattern) and two showed immature (monophasic pattern) waveforms before surgery. After anaesthesia, all showed the monophasic waveform (p = 0.01). Thus, the sphincteric action of VUJ as manifest by the complexity of the ureteric jet was modified by anaesthesia by loss of the complex pattern. This supports the hypothesis that the complex pattern is a neural modulation of the simpler myogenic mechanism that produces the monophasic jet.