Anatomy & Embryology
Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed in MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Anatomy of the ureter. Which one is TRUE?Along its course, the ureter passes in front of the gonadal vessels and behind the bifurcation of the common iliac vessels.The wall of the ureter has three layers.The ureter originates in front of the renal artery.The blood supply to the ureter includes the middle rectal artery.There are two areas of narrowing along the length of the ureter.
The urinary tract and male reproductive system
C. Simon Herrington in Muir's Textbook of Pathology, 2020
Developmental anomalies involving the genitourinary tract are the most common group of congenital abnormalities and are estimated to occur in 10% of the population. Their clinical significance may be minimal and in a large proportion of cases are only discovered incidentally. Bifid ureter and duplex ureter are the most frequent ureteral anomalies and may be asymptomatic. Conditions such as refluxing mega-ureter and utero-pelvic junction obstruction present with urinary tract infections and usually require surgical intervention. Bilateral renal agenesis (Potter's syndrome) is lethal due to its association with pulmonary hypoplasia and is defined by the absence of kidneys and ureters. Agenesis of the urinary bladder is very rare and is the result of a complete failure of its development. Exstrophy is relatively common and is represented by incomplete closure of the bladder. This malformation may be associated with other urinary tract defects, particularly epispadias and with cloacal abnormalities.
Upper urinary tract obstructions
Prem Puri in Newborn Surgery, 2017
Intrinsic obstruction results from failure of transmission of the peristaltic waves across the PUJ with failure of urine to be propulsed from the renal pelvis into the ureter, which results in multiple ineffective peristaltic waves that eventually causes hydronephrosis by incompletely emptying the pelvic contents.8–11 Tainio et al.12 have shown the abnormalities of peptidergic innervation with dense innervation of neuropeptide Y and vasoactive intestinal polypeptide, and proposed that these may have a role in intrinsic obstruction. Absence or reduction of smooth muscle with replacement by collagen fibers has been demonstrated histologically.13,14 Some researchers proposed that downregulation of Cajal cells is responsible for the development of PUJ obstruction.15 Extrinsic mechanical factors include aberrant renal vessels, bands, adventitial tissues, and adhesions that cause angulation, kinking, or compression of the PUJ. Extrinsic obstruction may occur alone but usually coexists with intrinsic ureteropelvic junction pathology. Secondary PUJ obstruction may develop as a consequence of severe VUR in which a tortuous ureter may kink proximately.16 Previous reports have described VUR in 9%–15% of children who have PUJ obstruction, although the fractions that are secondary to reflux are difficult to determine.9,16
Incomplete Renal Duplex System with Lower Moiety Hydroureteronephrosis Due to Aberrant Blood Vessel
Published in Fetal and Pediatric Pathology, 2022
Hassan Alhellani, Fabio Beretta, Michele Corroppolo, Federica Fati, Giosuè Mazzero, Elisa Pani, Clara Revetria, Hamid Reza Sadri, Enrico Ciardini
A ureter receives blood supply from different vessels; abdominal ureter gets ramifications of renal, gonadal and even abdominal aorta. The pelvic ureter receives blood from a variety of adjacent arteries. Generally, abdominal ureter gets its blood supply from medial sources while pelvic ureter from lateral sources. Such vessels tend to have anastomosis over the course of the ureter creating a longitudinal plexus in its adventitia, which allows safe ureteral mobilization during surgery [4]. Venous and lymphatic drainage tend to follow the course of arterial vessels [5]. Duplicated systems have wide vascular variations [6] which makes it even harder to follow the course of each supplying vessel. The aim is to preserve connection between ureters when operating on duplicated systems to avoid vascular lesions and consequent ischemia of certain segments.
A novel biological model for training in percutaneous renal access
Published in Arab Journal of Urology, 2019
Mohankumar Vijayakumar, Sudharsan Balaji, Abhishek Singh, Arvind Ganpule, Ravindra Sabnis, Mahesh Desai
Both the bovine kidney and the chicken were purchased from the slaughter house. Specific precautions were taken whilst procuring the bovine kidney so as to preserve maximal ureteric length and perinephric fat. The ureter is identified and a ureteric catheter of adequate size is placed in the ureter to the renal pelvis. The ureteric catheter is fixed to the ureter by a silk thread (Figure 1). The chicken carcass is completely eviscerated and cleaned so that adequate space is made for placement of the bovine kidney (Figure 2). The bovine kidney is placed in such a way that the calyces are perpendicular to the chicken (Figure 3). After placing the bovine kidney inside the chicken carcass and confirming the position, both the walls of the chicken carcass are sutured keeping the ureteric catheter outside (Figure 4).
A two way fully coupled fluid structure simulation of human ureter peristalsis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Ahmed Tasnub Takaddus, Abhilash J. Chandy
The ureter is approximately a 30 cm long tube that connects the kidney to the bladder (Guyton and Hall 2006). Urine is carried through the ureter with isolated boluses moving from kidney to the bladder (van Mastrigt and Tauecchio 1984), known as the peristalsis mechanism. Understanding the peristaltic mechanism is critical, considering the improvement of treatment procedures for anomalies related to ureter peristalsis; say for instance, back-flow of urine from bladder to kidney known as vesicoureteric reflux or, malfunctioning of ureterobesical junction due to congentinal defects (Marieb et al. 2013). Various numerical studies have been performed to understand the urine transport mechanism. Earlier studies only included the fluid domain, and the ureter was modeled as channels or pipes. A lot of these studies modeled ureter peristalsis as a continuous series of sinusoidal waves (Burns and Parkes 1967; Fung and Yih 1968; Yin and Fung 1969; Chow 1970; Shapiro et al. 1969; Jimenez Lozano 2009; Najafi 2015; Najafi et al. 2016). Lykoudis and Roos 1970 was the first to point out that, peristalsis is not a sinusoidal function, and they presented it as an algebraic expression. Griffiths 1987; Griffiths 1989 studied the peristaltic motion and described it as a series of compression waves.
Related Knowledge Centers
- Birth Defect
- Bladder
- Smooth Muscle
- Transitional Epithelium
- Urinary Tract Infection
- Urination
- Urine
- Peristalsis
- Kidney
- Kidney Stone Disease