Ureteral Structure and Ultrastructure. Part III. The Congenitally Dilated Ureter (Megaureter)

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Abstract
A selected group of congenitally dilated ureters [in humans] was examined by light microscopy and EM, and the findings were compared to the clinicoradiologic features of each ureter. The dilated ureters exhibited qualitative and/or quantitative muscular deficiencies. The obstructed megaureters secondary to posterior urethral valves and the megaureters with reflux showed non-specific pathologic changes in response to increased work load or decompensation but infection within the ureter was detrimental to the muscle cells. The ureters in babies with prune belly syndrome suffered from reduced muscle cell population and a distinct myopathy involving the myofilaments within the muscle cells. The dysplastic ureter was morphologically an end stage ureter wherein the muscle cells were severely compromised. Whether this was due to underdevelopment or exhaustion from repeated infections was a matter for speculation.