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Development of Urogenital System

THE URINARY SYSTEM

*THE KIDNEYS, which excrete urine
*THE URETERS, which convey urine from the kidneys to the urinary bladder
*THE URINARY BLADDER, which stores urine temporarily
*THE URETHRA, which carries urine from the bladder to the exterior of the body

DEVELOPMENT OF URINARY SYSTEM

Urinary system develops before the genital system.
Both systems develop from intermediate mesoderm
Three overlapping kidney system forms in succession in cranial to caudal sequence.

PHYLOGENETIC STAGES OF OVERLAPPING EXCRETORY ORGANS

Pronephros, a structure similar to that found in primitive vertebrates (fish).
Mesonephros, a more advanced system found in amphibia.
Metanephros which elaborates into the final human form.

PRONEPHROS(EARLY 4th WEEK)

*Rudimentary, transitory and non functional
*Represented by 7 to 10 solid cell groups in cervical region
*Forms vestigial excretory units, nephrotomes
*No glomeruli

*No connection b/w pronephric duct and excretory tubules
*Cranial regress before more caudal ones are formed
*End of 4 wks – Disappears

MESONEPHROS/ INTERIM KIDNEYS FUNCTION FOR 4 WKS (upper thoracic to upper Lumber L3 segments )

*Formation of glomerulus and S- shaped excretory tubules (Increase in length causes it to bend)
*Formation of Bowman’s capsule
*Tubules enter into mesonephric/ Wolffian duct, a continuation of the pronephric duct
*Function for a short time for about 4 weeks

*IN THE MIDDLE OF SECOND MONTH
*Formation of urogenital ridge
*While caudal tubules are differentiating, cranial tubules & glomeruli show degenerative changes
*BY THE END OF SECOND MONTH:
*Mesonephric ducts open into cloaca & persist in males as epididymis, vasdeferens, ejaculatory ducts,seminal vesicles
*Few caudal tubules persist – Efferent ductules of testes

METANEPHROS/
DEFINITIVE KIDNEY

*Appears in 5th wk, lies in pelvic region
*Permanent kidney develops from two sources:
*Metanephric diverticulum / Ureteric bud
*Metanephric blastema (mass of unsegmented mesoderm)

REASONS FOR THE ASCEND OF KIDNEYS

1.Dimunition of body curvature
2.Growth of the body in lumber & sacral regions
Arterial supply changes as it ascends

RECIPROCAL INDUCTION TO FORM PERMANENT KIDNEYS

•The ureteric bud is essential for induction  & differentiation in the metanephric mesoderm.
•The metanephric cap is essential for bifurcation of the ureteric bud.
•The collecting ducts are essential for differentiation of the nephrons.

*Metanephric diverticulum
is the primodium of:
•Ureters
•Renal pelvis
•Calyces
•Collecting tubules
*Metanephric blastema
is the primodium of:
Nephrons

FUNCTION OF THE KIDNEY

•Becomes functional by 12th week
•During fetal life kidneys are NOT responsible for excretion of waste products

WILM’S TUMOR / NEPHROBLASTOMA

•Cancer of kidneys usually unilateral affects children by 5 years of age
•Due to mutation in genes
•Encapsulated & vascularised

RENAL DYSPLASIAS & AGENESIS

may arise if the interaction between the metanephric mesoderm and the ureteric bud fails to occur.
•Cause:
Genes Mutations
Potters sequence: Anuria, oligohydroamnios & hypoplastic lungs

AUTOSOMAL RECESSIVE POLYCYSTIC KIDNEY DISEASE

*Occurs in 1/5,000 births
*A progressive disorder in which cysts form from collecting ducts.
*The kidneys become very large, and renal failure occurs in infancy or childhood

AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE

*Cysts form from all segments of the nephron and usually do not cause renal failure until adulthood.
*More common (1/500 or 1/1,000 births) but less progressive than the autosomal recessive disease

DUPLICATION OF THE URETER

*Results from early splitting of ureteric bud
*Complete or Partial

ABNORMAL LOCATION OF THE KIDNEY

*Pelvic kidney-— if fails to pass through arterial fork formed by umbilical arteries.
*Horse shoe kidney-— pushed close during passage; lower lumbar vertebra; ascent prevented by root of Inferior Mesentric Artery

DEVELOPMENT OF URINARY BLADDER

*During 4th to 7th week of development, the cloaca divides into urogenital sinus anteriorly & the anal canal posteriorly
*Urorectal septum – Formation of perineal body

*Three portions of urogenital sinus:
* Upper, largest part is Vesical part: Urinary bladder
* Pelvic part: Prostatic and membranous part of urethra
* Phallic part : Penile urethra

*During differentiation of cloaca, the caudal portions of mesonephric ducts are absorbed into the wall of urinary bladder
*Mucosa of trigone initially mesodermal & later endodermal

DEVELOPMENT OF URETHRA

*Origin of epithelium — endoderm
*Surrounding C.T. and smooth muscle — splanchnic mesoderm
*At the end of 3rd month, epithelium of prostatic urethra begins to proliferate and forms a number of outgrowths that penetrate the surrounding mesenchyme

*In the male, these buds form the PROSTATE GLAND
*In the female, the cranial part of urethra gives rise to the URETHRAL AND PARAURETHRAL GLANDS

BLADDER DEFECTS

*URACHAL FISTULA
*URACHAL CYST
*URACHAL SINUS

EXSTPROPHY OF BLADDER

*Ventral body wall defect, bladder mucosa is exposed
*Epispadias is a constant feature
*Caused by lack of mesodermal migration into the region between umbilicus and genital tubercle followed by rupture of thin layer of ectoderm
*This anomaly is rare, occurring in 2/100000 live births




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