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Ureteral structure and ultrastructure. Part V. The dysplastic ureter
The Journal of Urology
|December 1, 1979
Summary
Neonatal ureteral dysplasia involves severe anatomical and functional ureter compromise. Key features include dilation, poor motility, and microscopic abnormalities, often linked to congenital causes.
Area of Science:
- Pediatric Urology
- Developmental Biology
- Pathology
Background:
- Ureteral abnormalities in neonates and infants can be severe enough to be classified as dysplasia.
- This condition significantly impacts ureteral anatomy and function from early life.
Purpose of the Study:
- To define the clinicopathologic criteria for diagnosing ureteral dysplasia in neonates and infants.
- To explore the potential etiology of congenital ureteral dysplasia.
Main Methods:
- Excretory urography and cystography to assess ureteral dilation.
- Cine-fluoroscopy and operative observation to evaluate ureteral motility.
- Light and electron microscopy to analyze ureteral tissue structure, muscularization, cell morphology, and organelles.
- Histochemical analysis for collagen and ground substance content.
Main Results:
- Diagnosis is based on ureteral dilation, poor/absent motility, reduced muscle/connective tissue ratio, and abnormal microscopic features (small, deformed muscle cells, decreased nexuses, poorly defined organelles).
- Excessive collagen and ground substance are characteristic findings.
- These abnormalities, while non-specific, are severe in early postnatal life.
Conclusions:
- The described structural abnormalities in ureters of neonates and infants meet criteria for dysplasia.
- While prenatal obstruction and postnatal infection can cause similar changes, their severity and association with dysplastic kidneys suggest congenital dysplasia as the primary etiology.