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Morphological study of the ureterovesical junction in children

Ryszard Makosiej1, Stanisław Orkisz2, Elżbieta Czkwianianc1

  • 1Department of Gastroenterology, Allergology and Pediatrics, Research Institute, Polish Mother Memorial Hospital, Lodz, Poland.

Journal of Anatomy
|February 13, 2018
PubMed

Insights

This study investigated the ureterovesical junction in children, finding no inherited susceptibility to reflux. Anatomical predisposition to primary vesicoureteral reflux may occur between 28 and 37 weeks of gestation.

Area of Science:

  • Pediatric Urology
  • Developmental Anatomy
  • Urology

Background:

  • The ureterovesical junction (UVJ) is crucial for preventing vesicoureteral reflux (VUR).
  • Understanding UVJ development is key to identifying predispositions to VUR.
  • Primary VUR in children often lacks a clear genetic cause.

Purpose of the Study:

  • To assess the morphological and morphometric development of the UVJ in human ontogenesis.
  • To determine if a specific developmental period presents an anatomical predisposition to primary VUR.
  • To investigate the role of inherited susceptibility in UVJ development.

Main Methods:

  • Morphological and morphometric analysis of 210 urinary bladders and juxtavesical ureters from autopsies.
  • Inclusion of diverse age groups, from 24 weeks gestation to 16 years old.
  • Comparative analysis across different developmental stages.

Main Results:

  • No evidence of inherited susceptibility impacting UVJ development in uncomplicated pregnancies.
  • A hypothesis suggesting anatomical predisposition to primary VUR between 28-37 weeks gestation (Age Group II).
  • Essential antireflux mechanism parameters observed even in later developmental stages (Age Group VI).

Conclusions:

  • Normal UVJ development is not influenced by inherited susceptibility.
  • A critical window for anatomical predisposition to primary VUR may exist during late fetal development.
  • The complex interrelations within a functionally competent UVJ are not fully elucidated by anatomical parameters alone.

Keywords:
anatomy of the ureterovesical junctionchildrendevelopmental changes of the ureterovesical junction elements

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