Abstract
The upper and lower urinary tract includes the two urine-producing kidneys and the entire urinary-discharging system consisting of the renal pelvises, the ureters, the urinary bladder, and the urethra. The entire system extends from the retroperitoneum of the upper abdomen into the small pelvis; the urethra finally penetrates the pelvic floor. The clear sex differences essentially concern the course of the ureters and the urethra.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Special References
D. Miletić, Ž. Fučkar, A. Šustić, V. Mozetič, D. Štimac, G. Žauhar, Sonographic measurement of absolute and relative renal length in adults. J. Clin. Ultrasound 26(4), 185–189 (1998). https://doi.org/10.1002/(Sici)1097-0096(199805)26:4<185::Aid-Jcu1>3.0.Co;2-9
B. Cheong, R. Muthupillai, M.F. Rubin, S.D. Flamm, Normal values for renal length and volume as measured by magnetic resonance imaging. Clin. J. Am. Soc. Nephrol. 2(1), 38–45 (2007). https://doi.org/10.2215/CJN.00930306
N. Buchholz, F. Abbas, S.R. Biyabani, Q. Javed, J. Talati, M. Afzal, I. Rzvi, Ultrasonographic renal size in individuals without known renal disease. J. Pak. Med. Assoc. 96(1), 12–16 (2000)
M.M. Fernandes, C.C. Lemos, G.S. Lopes, E.P. Madeira, O.R. Santos, D. Dorigo, R. Bregman, Normal renal dimensions in a specific population. Int. Braz. J. Urol. 28(6), 510–515 (2002)
G. Inke, W. Schneider, U. Schneider, Anzahl der Papillen und der Pori uriniferi der menschlichen Niere. Anat. Anz. 118, 241–246 (1966)
J. Hodson, The lobar structure of the kidney. Br. J. Urol. 44(2), 246–261 (1972). https://doi.org/10.1111/j.1464-410X.1972.tb10072.x
J.R. Nyengaard, T.F. Bendtsen, Glomerular number and size in relation to age, kidney weight, and body surface in normal man. Anat. Rec. 232(2), 194–201 (1992). https://doi.org/10.1002/ar.1092320205
Y. Wang, J. Zhu, H.F. DeLuca, The vitamin D receptor in the proximal renal tubule is a key regulator of serum 1alpha,25-dihydroxyvitamin D(3). Am. J. Physiol. Endocrinol. Metab. 308(3), E201–E205 (2015). https://doi.org/10.1152/ajpendo.00422.2014
Q. Al-Awqati, Cell biology of the intercalated cell in the kidney. FEBS Lett. 587(13), 1911–1914 (2013). https://doi.org/10.1016/j.febslet.2013.05.007
Q. Al-Awqati, X.B. Gao, Differentiation of intercalated cells in the kidney. Physiology (Bethesda) 26(4), 266–272 (2011). https://doi.org/10.1152/physiol.00008.2011
T. Nagai, Y. Yasuoka, Y. Izumi, K. Horikawa, M. Kimura, Y. Nakayama, T. Uematsu, T. Fukuyama, T. Yamazaki, Y. Kohda, Y. Hasuike, M. Nanami, T. Kuragano, N. Kobayashi, M. Obinata, K. Tomita, A. Tanoue, T. Nakanishi, K. Kawahara, H. Nonoguchi, Reevaluation of erythropoietin production by the nephron. Biochem. Biophys. Res. Commun. 449(2), 222–228 (2014). https://doi.org/10.1016/j.bbrc.2014.05.014
R. Taugner, E. Hackenthal, The Juxtaglomerular Apparatus: Structure and Function (Springer, Berlin, Heidelberg, 2013). https://doi.org/10.1007/978-3-642-88426-9
N. Goormaghtigh, Histological changes in the ischemic kidney: With special reference to the juxtaglomerular apparatus. Am. J. Pathol. 16(4), 409–416 (1940)
L. Barajas, Innervation of the renal cortex. Fed. Proc. 37(5), 1192–1201 (1978)
M.P. Schlaich, D. Hering, P.A. Sobotka, H. Krum, M.D. Esler, Renal denervation in human hypertension: Mechanisms, current findings, and future prospects. Curr. Hypertens. Rep. 14(3), 247–253 (2012). https://doi.org/10.1007/s11906-012-0264-9
V.M. Campese, Neurogenic factors and hypertension in chronic renal failure. J. Nephrol. 10(4), 184–187 (1996)
A. Perlewitz, A.E. Persson, A. Patzak, The juxtaglomerular apparatus. Acta Physiol (Oxf.) 205(1), 6–8 (2012). https://doi.org/10.1111/j.1748-1716.2012.02429.x
R. Mahajan, A. Tuli, S. Raheja, Aberrant arterial anastomosis between kidney and paranephric fat vasculature-a serendipitous finding. Scholars J. Appl. Med. Sci. 3(3H), 1567–1569 (2015)
Y. Ishikawa, Y. Akasaka, H. Kiguchi, Y. Akishima-Fukasawa, T. Hasegawa, K. Ito, M. Kimura-Matsumoto, S. Ishiguro, H. Morita, S. Sato, S. Soh, T. Ishii, The human renal lymphatics under normal and pathological conditions. Histopathology 49(3), 265–273 (2006). https://doi.org/10.1111/j.1365-2559.2006.02478.x
S.M. Bonsib, Renal lymphatics, and lymphatic involvement in sinus vein invasive (pT3b) clear cell renal cell carcinoma: A study of 40 cases. Mod. Pathol. 19(5), 746–753 (2006). https://doi.org/10.1038/modpathol.3800589
H. Seeger, M. Bonani, S. Segerer, The role of lymphatics in renal inflammation. Nephrol. Dial. Transplant. 27(7), 2634–2641 (2012). https://doi.org/10.1093/ndt/gfs140
M.W. Tellman, C.D. Bahler, A.M. Shumate, R.L. Bacallao, C.P. Sundaram, Management of pain in autosomal dominant polycystic kidney disease and anatomy of renal innervation. J. Urol. 193(5), 1470–1478 (2015). https://doi.org/10.1016/j.juro.2014.10.124
S. Weltings, S. Hulsbos, G.J. Kieft, R.C.M. Pelger, H. Roshani, The anatomy of the renal pyelocaliceal system studied by CTU. Abdom. Radiol. (NY) 44(2), 612–618 (2019). https://doi.org/10.1007/s00261-018-1767-x
M.P. Burykh, Renal excretory sectors. Surg. Radiol. Anat. 24(3–4), 201–204 (2002). https://doi.org/10.1007/s00276-002-0046-1
F.J. Barcellos Sampaio, C.A. Mandarim-de-Lacerda, 3-dimensional and radiological pelviocaliceal anatomy for endourology. J. Urol. 140(6), 1352–1355 (1988). https://doi.org/10.1016/s0022-5347(17)42042-8
J.A. Gosling, The musculature of the upper urinary tract. Acta Anat. (Basel) 75(3), 408–422 (1970). https://doi.org/10.1159/000143460
M. Pavelka, J. Roth, Urothelium, in Functional Ultrastructure: Atlas of Tissue Biology and Pathology, (Springer, Vienna, 2015), pp. 290–293. https://doi.org/10.1007/978-3-7091-1830-6_19
M.G. Dalghi, N. Montalbetti, M.D. Carattino, G. Apodaca, The urothelium: Life in a liquid environment. Physiol. Rev. 100(4), 1621–1705 (2020). https://doi.org/10.1152/physrev.00041.2019
R. Mulţescu, D. Georgescu, P.A. Geavlete, B. Geavlete, Notions of histology, anatomy, and physiology of the upper urinary tact, in Retrograde Ureteroscopy, ed. by P. A. Geavlete, (Academic Press, San Diego, 2016), pp. 7–19. https://doi.org/10.1016/b978-0-12-802403-4.00002-4
T. Walz, M. Haner, X.R. Wu, C. Henn, A. Engel, T.T. Sun, U. Aebi, Towards the molecular architecture of the asymmetric unit membrane of the mammalian urinary-bladder epithelium - a closed twisted ribbon structure. J. Mol. Biol. 248(5), 887–900 (1995). https://doi.org/10.1006/jmbi.1995.0269
G.J. Netto, J.I. Epstein, Immunohistology of the prostate, bladder, kidney, and testis, in Diagnostic Immunohistochemistry, ed. by D. J. Dabbs, (W.B. Saunders, Philadelphia, 2011), pp. 593–661. https://doi.org/10.1016/b978-1-4160-5766-6.00020-0
L. Birder, K.E. Andersson, Urothelial signaling. Physiol. Rev. 93(2), 653–680 (2013). https://doi.org/10.1152/physrev.00030.2012
G. Apodaca, E. Balestreire, L.A. Birder, The uroepithelial-associated sensory web. Kidney Int. 72(9), 1057–1064 (2007). https://doi.org/10.1038/sj.ki.5002439
L. Nemeth, D.S. O’Briain, P. Puri, Demonstration of neuronal networks in the human upper urinary tract using confocal laser scanning microscopy. J. Urol. 166(1), 255–258 (2001). https://doi.org/10.1016/S0022-5347(05)66140-X
J.A. Gosling, C.E. Constantinou, The origin and propagation of upper urinary tract contraction waves. A new in vitro methodology. Experientia 32(2), 266–267 (1976)
J.S. Dixon, J.A. Gosling, The musculature of the human renal calices, pelvis and upper ureter. J. Anat. 135(Pt 1), 129–137 (1982)
R. Fröber, Surgical anatomy of the ureter. BJU Int. 100(4), 949–965 (2007). https://doi.org/10.1111/j.1464-410X.2007.07207.x
M. Kamo, T. Nozaki, S. Horiuchi, N. Muraishi, J. Yamamura, K. Akita, There are no three physiological narrowings in the upper urinary tract: A new concept of the retroperitoneal anatomy around the ureter. Jpn. J. Radiol. 39(5), 407–413 (2021). https://doi.org/10.1007/s11604-020-01080-7
G. Bartsch, S. Poisel, Approaches in Urologic Surgery (Thieme, Stuttgart - New York, 1994)
J. Oswald, E. Brenner, M. Deibl, H. Fritsch, G. Bartsch, C. Radmayr, Longitudinal and thickness measurement of the normal distal and intravesical ureter in human fetuses. J. Urol. 169(4), 1501–1504 (2003). https://doi.org/10.1097/01.ju.0000057047.82984.7f
A. Gisel, Ureter, Harnleiter, in Anatomie Und Embryologie. Handbuch der Urologie Encyclopedia of Urology Encyclopédie d’Urologie, vol. 1, (Springer, Berlin, Heidelberg, 1969), pp. 225–252. https://doi.org/10.1007/978-3-642-48164-2_5
G. Burnstock, Purinergic signalling in the lower urinary tract. Acta Physiol (Oxf.) 207(1), 40–52 (2013). https://doi.org/10.1111/apha.12012
Bolla SR, Odeluga N, Jetti R (2021) Histology, bladder. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540963/. Accessed 8 July 2021
F. Aigner, A.P. Zbar, B. Ludwikowski, A. Kreczy, P. Kovacs, H. Fritsch, The rectogenital septum: Morphology, function, and clinical relevance. Dis. Colon Rectum 47(2), 131–140 (2004). https://doi.org/10.1007/s10350-003-0031-8
C.P. Denonvilliers, Anatomie du perinée. Bull. Soc. Anat. 11, 105–106 (1836)
M.B. Wesson, The development and surgical importance of the rectourethralis muscle and Denonvilliers’ fascia. J. Urol. 8(4), 339–359 (1922). https://doi.org/10.1016/S0022-5347(17)73819-0
O. Cappele, L. Sibert, J. Descargues, V. Delmas, P. Grise, A study of the anatomic features of the duct of the urachus. Surg. Radiol. Anat. 23(4), 229–235 (2001). https://doi.org/10.1007/s00276-001-0229-1
R.C. Begg, The urachus: Its anatomy, histology and development. J. Anat. 64(Pt 2), 170–183 (1930)
G. Hammond, L. Yglesias, J.E. Davis, The urachus, its anatomy and associated fasciae. Anat. Rec. 80(3), 271–287 (1941). https://doi.org/10.1002/ar.1090800302
R.T. Woodburne, The ureter, ureterovesical junction, and vesical trigone. Anat. Rec. 151(3), 243–249 (1965). https://doi.org/10.1002/ar.1091510305
A. Mangera, N.I. Osman, C.R. Chapple, Anatomy of the lower urinary tract. Surgery (Oxford) 31(7), 319–325 (2013). https://doi.org/10.1016/j.mpsur.2013.04.013
H. John, X. Wang, E. Wehrli, D. Hauri, C. Maake, Evidence of gap junctions in the stable nonobstructed human bladder. J. Urol. 169(2), 745–749 (2003). https://doi.org/10.1097/01.ju.0000045140.86986.a7
K.E. Andersson, A. Arner, Urinary bladder contraction and relaxation: Physiology and pathophysiology. Physiol. Rev. 84(3), 935–986 (2004). https://doi.org/10.1152/physrev.00038.2003
W. Dorschner, J.U. Stolzenburg, J. Neuhaus, Structure and function of the bladder neck. Adv. Anat. Embryol. Cell Biol. 159(III-XII), 1–109 (2001). https://doi.org/10.1007/978-3-642-56879-4
J. Sultana, M. Khalil, S.Z. Sultana, S. Mannan, S. Choudhury, A. Ara, M.S. Sumi, T. Farzana, R. Sultana, A.H. Tania, Variations of thickness of trigonal muscle layer in different age and sex. Mymensingh Med. J. 23(4), 672–675 (2014)
H. Roshani, N.F. Dabhoiwala, F.J. Verbeek, W.H. Lamers, Functional anatomy of the human ureterovesical junction. Anat. Rec. 245(4), 645–651 (1996). https://doi.org/10.1002/(SICI)1097-0185(199608)245:4<645::AID-AR4>3.0.CO;2-N
J.W. Noordzij, N.F. Dabhoiwala, A view on the anatomy of the ureterovesical junction. Scand. J. Urol. Nephrol. 27(3), 371–380 (1993). https://doi.org/10.3109/00365599309180449
P. Kluck, The autonomic innervation of the human urinary bladder, bladder neck and urethra: A histochemical study. Anat. Rec. 198(3), 439–447 (1980). https://doi.org/10.1002/ar.1091980306
J. Oswald, I. Heidegger, E. Steiner, E. Brenner, M. Ladurner Rennau, R. Pichler, T. Becker, W. Loidl, W. Horninger, H. Fritsch, Gender-related fetal development of the internal urethral sphincter. Urology 82(6), 1410–1415 (2013). https://doi.org/10.1016/j.urology.2013.03.096
S.A. Gilpin, J.A. Gosling, Smooth muscle in the wall of the developing human urinary bladder and urethra. J. Anat. 137(Pt 3), 503–512 (1983)
E.J. Pechriggl, M. Bitsche, M.J. Blumer, M.E. Zwierzina, H. Fritsch, Novel immunohistochemical data indicate that the female foetal urethra is more than an epithelial tube. Ann. Anat. 195(6), 586–595 (2013). https://doi.org/10.1016/j.aanat.2013.09.004
A. Shafik, O. El-Sibai, A.A. Shafik, I. Shafik, Identification of interstitial cells of Cajal in human urinary bladder: Concept of vesical pacemaker. Urology 64(4), 809–813 (2004). https://doi.org/10.1016/j.urology.2004.05.031
B.T. Drumm, S.D. Koh, K.E. Andersson, S.M. Ward, Calcium signalling in Cajal-like interstitial cells of the lower urinary tract. Nat. Rev. Urol. 11(10), 555–564 (2014). https://doi.org/10.1038/nrurol.2014.241
K.E. Andersson, K.D. McCloskey, Lamina propria: The functional center of the bladder? Neurourol. Urodyn. 33(1), 9–16 (2014). https://doi.org/10.1002/nau.22465
L.A. Birder, Urinary bladder urothelium: Molecular sensors of chemical/thermal/mechanical stimuli. Vasc. Pharmacol. 45(4), 221–226 (2006). https://doi.org/10.1016/j.vph.2005.08.027
A.J. Miodonski, J.A. Litwin, Microvascular architecture of the human urinary bladder wall: A corrosion casting study. Anat. Rec. 254(3), 375–381 (1999). https://doi.org/10.1002/(SICI)1097-0185(19990301)254:3<375::AID-AR8>3.0.CO;2-R
P. Poggi, C. Marchetti, A. Tazzi, R. Scelsi, The lymphatic vessels and their relationship to lymph formation in the human urinary bladder. Lymphology 28(1), 35–40 (1995)
K. Matsumoto, S. Soh, T. Satoh, M. Iwamura, Y. Ishikawa, T. Ishii, S. Baba, Distribution of lymphatic vessel network in normal urinary bladder. Urology 72(3), 706–710 (2008). https://doi.org/10.1016/j.urology.2007.12.061
J.O. DeLancey, J. Gosling, K. Creed, J. Dixon, V. Delmas, D. Landon, P. Norton, Gross anatomy and cell biology of the lower urinary tract, in Incontinence, ed. by P. Abrams, L. Cardozo, S. Khoury, A. Wein, 2nd edn., (Health Publication Ltd., Birmingham, 2002), pp. 17–82
J.O. DeLancey, Correlative study of paraurethral anatomy. Obstet. Gynecol. 68(1), 91–97 (1986)
H. Fritsch, G.M. Pinggera, A. Lienemann, M. Mitterberger, G. Bartsch, H. Strasser, What are the supportive structures of the female urethra? Neurourol. Urodyn. 25(2), 128–134 (2006). https://doi.org/10.1002/nau.20133
J. Jung, H.K. Ahn, Y. Huh, Clinical and functional anatomy of the urethral sphincter. Int. Neurourol. J. 16(3), 102–106 (2012). https://doi.org/10.5213/inj.2012.16.3.102
W. Dietrich, M. Susani, L. Stifter, A. Haitel, The human female prostate—Immunohistochemical study with prostate-specific antigen, prostate-specific alkaline phosphatase, and androgen receptor and 3-D remodeling. J. Sex. Med. 8(10), 2816–2821 (2011). https://doi.org/10.1111/j.1743-6109.2011.02408.x
N. Wernert, M. Albrech, I. Sesterhenn, R. Goebbels, H. Bonkhoff, G. Seitz, R. Inniger, K. Remberger, The female ‘prostate’: Location, morphology, immunohistochemical characteristics and significance. Eur. Urol. 22(1), 64–69 (1992). https://doi.org/10.1159/000474724
I. Karam, S. Droupy, I. Abd-Alsamad, J.F. Uhl, G. Benoit, V. Delmas, Innervation of the female human urethral sphincter: 3D reconstruction of immunohistochemical studies in the fetus. Eur. Urol. 47(5), 627–633; discussion 634 (2005). https://doi.org/10.1016/j.eururo.2005.01.001
I. Karam, S. Droupy, I. Abd-Alsamad, A. Korbage, J.F. Uhl, G. Benoit, V. Delmas, The precise location and nature of the nerves to the male human urethra: Histological and immunohistochemical studies with three-dimensional reconstruction. Eur. Urol. 48(5), 858–864 (2005). https://doi.org/10.1016/j.eururo.2005.03.016
Main Reference Used for This Chapter
P.L. Williams, R. Warwick, M. Dyson, L. Bannister, Gray's anatomy, 37th edn. (Churchill Livingstone, Edinburgh, 1989)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Singapore Pte Ltd.
About this entry
Cite this entry
Brenner, E. (2023). Functional Anatomy of the Upper and Lower Urinary Tract. In: Liao, L., Madersbacher, H. (eds) Handbook of Neurourology. Springer, Singapore. https://doi.org/10.1007/978-981-99-1659-7_1
Download citation
DOI: https://doi.org/10.1007/978-981-99-1659-7_1
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-99-1658-0
Online ISBN: 978-981-99-1659-7
eBook Packages: MedicineReference Module Medicine