Jw. Noordzij et Nf. Dabhoiwala, A VIEW ON THE ANATOMY OF THE URETEROVESICAL JUNCTION, Scandinavian journal of urology and nephrology, 27(3), 1993, pp. 371-380
Macro- and microscopic dissection of 8 adult and 2 fetal human bladder
s was undertaken in two directions as part of a study to evaluate uret
erovesical junction function. In the trigonal region the detrusor musc
le consists of 3, more or less triangular layers. Both ureters are onl
y loosely enveloped by a fibromuscular sheath of mainly bladder origin
. This design allows for easy movement of the ureters on their oblique
course through the bladder wall. The ureteral muscle fibers play only
a minor part in the sheath or join the detrusor muscle. The majority
fan out to end at the bladder mucosa or intermingle with fibers origin
ating from the opposite ureter. Since an intricate muscular structure
can be demonstrated, an active anti-reflux muscular component in the n
ormal human bladder seems plausible. A classic ureteral sphincter mech
anism does not exist. Our findings are discussed and compared with dat
a from the literature.