THE
UROGENITAL SYSTEM
INTRODUCTION
The term "genitourinary" actually refers to two
different systems.
Urinary refers to the system responsible for
removal of nitrogenous waste products of
metabolism from the bloodstream, disposal of
concentrated wastes (urine), and also water
conservation.
Genito refers to the genital organs and the
reproductive system, which is responsible for
production of succeeding generations for
perpetuation of the species.
THE
URINARY SYSTEM
The urinary system is made up of
i. Two Kidneys
ii. Two Ureters
iii. One Urinary Bladder
iv. One Urethra.
THE
GENITAL SYSTEM
THE MALE GENITAL SYSTEM
a. External Genitalia. The penis and the
scrotum are the external parts of the male
genital system
b. Internal Genitalia. Internal genitalia
include the testes, epididymis, vas deferens,
ductus deferens, seminal vesicles,
ejaculatory duct, prostrate gland,
bulbourethral (Cowper's) gland, and the
urethra.
THE FEMALE GENITAL SYSTEM
a. External Genitalia (or vulva) consist of
the outlying structures mons pubis, labia
majora, labia minora, clitoris, vestibule,
hymen, Bartholin's glands, external urethra
meatus, and Skene's gland.
b. Internal Genitalia including the female
reproductive system, consists of the vagina,
the uterus, the two fallopian tubes, and the
two ovaries.
OVERVIEW
OF
GERM LAYER
DERIVATIVES
DEVELOPMENT
OF
URINARY SYSTEM
AND
ANOMALIES
THE MAIN FUNCTIONS OF THE URINARY
SYSTEM INCLUDE:
i. Removal of metabolic waste
products such as uric acid, urea and
creatinine.
ii. Maintain electrolyte, water and pH
balance.
iii. Regulation of blood pressure, blood
volume and erythropoiesis, and
vitamin D production.
Development of the urinary system is
closely related to the development of
the reproductive system; particularly
during the earlier stages – where they
develop from the same origin. However, the
urinary system develops ahead of the
reproductive system.
The urinary system consists of the
i. Kidneys which excrete urine
ii. Ureters which convey urine from
the kidneys to the bladder
iii. Bladder which stores urine
temporarily
iv. Urethra which carries urine from
the bladder to the exterior
The urogenital system arises from the
intermediate mesoderm which forms
a urogenital ridge on either side of the
aorta.
[Link] tube
[Link]
[Link] dorsalis
[Link] mesentery
[Link] tube
[Link]
[Link]
[Link] cardinal
vein
[Link] duct
(Wolffian duct)
[Link]
tubule
[Link] ridge
The kidney pass through 3 stages of
evolution
i. Pronephros-cervical region
ii. Mesonephros-thoracolumbar region
iii. Metanephros- sacral region
Development of the Kidneys
In the embryo, the kidneys develop from
three overlapping sequential systems;
i. 1ST Set :The Pronephros rudimentary
ii. 2ND Set : The Mesonephros well
developed but function briefly
iii. 3RD Set : The Metanephros become
the permanent kidneys.
They are all derived from the urogenital
ridge.
KIDNEY SYSTEM LEVEL APPEARANCE DISAPPEARANCE
PRONEPHROS cervical 4th week begining 4th week end
MESONEPHROS Upper thoracic- 4th week early 2nd month end
upper lumbar
METANEPHROS sacral 5th
THE MESONEPHRIC KIDNEY
CONSISTS OF
1) Glomerulus
2) Mesonephric Tubule
3) Mesonephric Duct
Mesonephric kidney
fails to perform the
function of permanent
kidney.
METANEPHROS
Appears in 5th week
The definitive human kidney consists of
i. Collecting part from URETERIC BUD
ii. Excretory part from METANEPHRIC
BLASTEMA
iii. Angiogenic mesenchyme (The formative,
undifferentiated material from which cells
are formed)
COLLECTING PART
from
URETERIC BUD
Ureteric Bud dilates to form
Primitive Renal Pelvis
Splits into cranial & caudal portions:
Future MAJOR CALYCES
►Each calyx forms 2 new buds
while penetrating metanephric
tissue
►Buds continue to subdivide until
12 or more generations of tubules
►Until 5th month tubules form
►The branches of 2nd,3rd,4th
orders are absorbed to form the
minor calyces
►All branches from the 5th and
subsequent orders persists as the
collecting tubules of the
permanent kidney.
►They converge on minor calyx
forming renal pyramid
DERIVATIVES OF URETERIC BUD
a. Ureter
b. Renal pelvis
c. Major calyces
d. Minor calyces
e. 1-3million collecting tubules
EXCRETORY PART
from
METANEPHRIC BLASTEMA
►Each newly formed collecting tubule is
covered at its distal end by metanephric
tissue cap
►Under inductive influence of tubule.
Cells of tissue cap form renal vesicles
►These vesicles are the precursors of
the nephrons of the kidney
►Renal vesicles give rise to S-shaped tubules
►Proximal end of tubule get deeply indented to form
Bowman’s capsule
►Capillaries grow into the pocket & differentiate into
glomeruli
►Distal end of S-shaped tubule forms
open connection with collecting tubule.
Continuous lengthening
of excretory tubule
results in formation of
i. Proximal
Convoluted Tubule
ii. Loop of Henle
iii. Distal Convoluted
Tubule
TIME LINES
Beginning of 4th week: PRONEPHROS: 7-10
cell groups
End of 4th week: pronephric system disappear
Early in 4th week: excretory tubules of
MESONEPHROS appear
Middle of 2nd month: mesonephros is large ovoid
organ
End of 2nd month: mesonephric tubules
degenerate mostly
5th week: METANEPHROS appear
Nephrons are formed until birth
At birth approximately 1 million in each kidney
The tubular function comes out at about the 9th
week
Differentiation of glomerular capillaries start
from 10th week
Urine production follows soon.
Definitive kidney formed from metanephros
becomes functional near 12th week
Reabsorption of filtrate by the loop of Henle
takes place at about the 13th week
ASCENT OF KIDNEY
FACTORS RESPONSIBLE FOR
THE ASCENT
• Continuous lengthening of the ureteric bud
• Diminution of the fetal curvature
• Growth of body in lumbar and sacral region
• Too small pelvic cavity for the accommodation of the
renal growth
ROTATION OF THE KIDNEY
ANOMALIES OF THE KIDNEY
i. Agenesis
ii. Hypoplasia/ Hyperplasia-underdeveloped/overdeveloped
iii. Hydronephrosis- distension of pelvis
iv. Duplication- extra kidney, separate or fused to normal
kidney
Unilateral renal agenesis
Bilateral Renal Agenesis
Hydronephrosis
Pelvic kidney
Failure of kidney to ascend through
arterial fork
Ectopic kidney
• Horse shoe kidney- lower poles fused
• Pancake kidney- 2 kidneys as 1 mass
• Lobulated kidney- fetal lobulation persists
Horseshoe kidney
Kidneys pushed together
during passage through
arterial fork
Lower lumber
Ascent prevented by
inferior mesenteric artery
Duplex kidney
ANOMALIES OF THE KIDNEY
Malrotated kidney: hilum directed
forwards (non rotation), anteromedially
(incomplete rotation), or anterolaterally (reverse
rotation),
•Congenital polycystic kidney
•Accessory renal artery: persistence of
embryonic vessels formed during ascent of
kidney
•Tumours of kidney: aniridia, hemihypertrophy,
Wilm’s tumour
Malrotated kidney
Polycystic kidney
AR: collecting duct cyst
AD: all segments of nephron
Multicystic dysplastic
kidney
Ducts surrounded by
undifferentiated cells
Nephron: fail to develop
Ureteric bud: fail to
branch→collec ng duct never
form
Duplication of urinary tract
DEVELOPMENT OF URETER
DEVELOPMENT OF URETER
The ureter is derived
from the part of the
ureteric bud that lies
between the pelvis of
the kidney and
vesicourethral canal.
CONGENITAL ANOMALIES
Bifid ureter: Splitting of the upper
part of the ureter.
Double ureter: Two separate ureters
due to formation of 2 ureteric buds.
Duplication of ureter
Ectopic ureter
DEVELOPMENT
OF
URINARY BLADDER
ALLANTOIC DIVERTICULUM
►Small endodermal diverticulum
►Arises from yolk sac near caudal
end of embryonic disc
►Diverticulum grows into mesoderm
of connecting stalk
CLOACA
Part of hindgut
caudal to
attachment of
allantoic
diverticulum is
known as cloaca
During 4-7th week cloaca gets divided into
urogenital sinus & anal canal by urorectal septum
Anal membrane
cloaca
Urogenital sinus rectum
Vesicourethral Pelvic part Phallic part
canal
• Lower part of prostatic • Spongy urethra in males
urethra • Vestibule in females
• Urinary bladder
• Upper part of • Membranous urethra
prostatic urethra
in males
• Entire urethra in
females
►Internal trigone of the
bladder - from mesoderm by
the incorporation of the
caudal part of the
mesonephric ducts.
►Mesodermal lining replaced
by endodermal epithelium
with time
• Mucosa of the bladder is derived from endoderm of
vesicourethral part of cloaca.
• Apex of the bladder is continuous with the allantoic
diverticulum.
• Musculature of the bladder are developed from the
splanchnopleuric layer of lateral plate mesoderm which
surrounds the cloaca
Anomalies of urinary bladder
► Ectopia vesicae
►Exstrophy of the cloaca
►Urachal fistula
► Urachal cyst
►Urachal sinus
►Congenital recto-vesical fistula
► Congenital vesico-vaginal fistula
Ectopic vesicae
Ventral body wall defect:
bladder mucosa exposed
Exstrophy of the cloaca
Ventral body wall defect:
Migration of mesoderm to
midline inhibited
Tail folds fail to progress
• Exstrophy of bladder
• Spinal defect
• ±meningomyelocele
• Imperforate anus
• omphalocele
►Urachal fistula
►Urachal cyst
►Urachal sinus
vesico-vaginal fistula
DEVELOPMENT
OF
URETHRA
URETHRA
►Epithelium: endoderm
►Connective tissue and smooth muscle:
splanchnic mesoderm
PROSTATE GLAND
►End of 3rd month: epithelium of
prostatic urethra
►Proliferate and forms outgrowths
penetrate surrounding mesenchyme
►Buds form prostate gland
►Cranial part of the urethra give
rise to urethral and paraurethral
glands
►third month
►from interactions between the urogenital sinus
mesenchyme and the endoderm of the proximal part of
the urethra.
► Early outgrowths
• 14 to 20 in number, arise from the endoderm around
the whole circumference of the tube, but mainly on its
lateral aspects and excluding the dorsal wall above the
utricular plate: outer glandular zone of the prostate.
► Later outgrowths from the dorsal wall above the
mesonephric ducts arise from the epithelium of mixed
urogenital, mesonephric and possibly paramesonephric,
origin that covers the cranial end of the sinus tubercle:
internal zone of glandular tissue.
►The outgrowths, which are at first solid,
branch, become tubular and invade the
surrounding mesenchyme.
► mesenchyme differentiates into smooth
muscle, associated blood and lymphatic vessels
and connective tissue and is invaded by
autonomic nerves.
►outgrowths in the female remain rudimentary in the absence
of androgenic stimulation.
►urethral glands correspond to the mucosal glands around the
upper part of the prostatic urethra,
►para-urethral glands correspond to the true prostatic glands of
the external zone.
►The bulbourethral glands in the male, and the greater
vestibular glands in the female, arise as diverticula from the
epithelial lining of the urogenital sinus.
DEVELOPMENT OF MALE
URETHRA
It is divided into three parts
1) Preprostatic & Prostatic Part
2) Membranous Part
3) Spongy Part
Prostatic part
Above the ejaculatory duct
►Vesicourethral canal-
caudal part
►Posterior
wall:
absorbed mesonephric
duct
Below the ejaculatory duct
pelvic part of urogenital
sinus
MEMBRANOUS
PART
It corresponds in
development with the
lower part of prostatic
urethra and is derived
from the pelvic part of
urogenital sinus
SPONGY PART
Up to the base of
glans penis
Develops from the
endoderm of the
phallic part of
urogenital sinus
•
Part of the urethra
within the glans
penis
Develops from the
ectodermal groove
which appears
longitudinally on
the under surface
of the glans penis
FEMALE URETHRA
►Vesicourethral canal-
caudal part
►Posterior
wall:
absorbed mesonephric
duct
ANOMALIES OF URETHRA
►Hypospadias: urethral meatus on inferior
aspect of penis
►Epispadias: urethral meatus on dorsum
of penis
►Congenital stenosis of urethra
Hypospadias
Types
1) Balanic Type
2) Penile Type
3) Complete Perineal Type
Epispadias
►Derivatives of ectoderm-lining epithelia of
terminal
Fate of part
germoflayers
male urethra
►Derivatives of endoderm-lining epithelia of
urinary bladder, female urethra, male urethra
►Derivatives of mesoderm-kidney, ureter,
trigone of the bladder, posterior part of female
urethra, post wall of upper half of prostatic part
of male urethra
THE
GENITAL SYSTEM