A. Shafik, Demonstration of a "renogastric reflex" after rapid distension of renal pelvis and ureter in nonanesthetized patients, UROLOGY, 53(1), 1999, pp. 38-43
Objectives. Renal or ureteral diseases are often associated with nausea, vo
miting, and abdominal pain. The aim of the current study was to investigate
the cause of gastric manifestations that accompany renoureteral disorders.
Methods. A 3F balloon-tipped catheter was introduced by means of a flexible
cystoscope into the renal pelvis of 14 healthy volunteers (mean age 38.6 y
ears; 10 men, 4 women), and the effect of rapid and slow renal pelvic and u
reteral distension on the pyloric sphincter, gastric corpus, lower esophage
al sphincter, and esophagus was recorded. The renal pelvis and ureter were
then anesthetized and the tests repeated.
Results. Rapid renal pelvic distension effected a significant rise in press
ure in the renal pelvis at the 6-mL distension and above and in the pyloric
sphincter at 10 and 12 mL. Loin and epigastric pain as well as nausea in a
ll subjects and vomiting in 5 occurred at the 10 and 12-mL distensions. Slo
w renal pelvic distension caused a renal pelvic pressure rise at the 8-mL d
istension and above but no pressure changes in the pyloric sphincter or gas
tric corpus; loin pain, but not nausea or vomiting, occurred. Rapid uretera
l distension at 1 mt was associated with loin and epigastric pain in all su
bjects and vomiting in 3. No epigastric pain, nausea, or vomiting occurred
with slow ureteral distension. Renal pelvic or ureteral distension, slow or
rapid, caused no pressure changes in the lower esophageal sphincter or eso
phagus. Distension of the anesthetized renal pelvis or ureter effected no g
astric or esophageal pressure changes and no nausea or vomiting.
Conclusions. The study demonstrated the possible existence of a reflex rela
tionship between the distension of the renal pelvis and ureter and the pres
sure of the pyloric sphincter. This reflex effect was reproducible and did
not occur when the anesthetized renal pelvis or ureter was distended. We ca
ll this reflex relationship the "renogastric reflex" and suggest that it ex
plains the cause of gastric manifestations that might occur with renoureter
al disorders. UROLOGY 53: 38-43, 1999. (C) 1999, Elsevier Science Inc. All
rights reserved.