An ultrastructural study of the urinary bladder in children correlated with histological, bacteriological, and clinical findings.

Abstract

SYNOPSIS Bladder biopsies from six boys without a history of urinary tract infection were taken during hypospadias repair operations and examined by electron microscopy. The ultrastructure of the epithelium, which was presumed to represent the normal, is described in detail and compared with the reported findings in other mammalian species. The appearances are generally similar although in our material the luminal membrane of the superficial cells was thicker than that surrounding the other epithelial cells but not asymmetrical. We observed membrane-coating granules which have not been reported before in bladder epithelium.The appearances of the normal bladder are compared to those seen in 24 children with urinary infection. In the presence of acute infection the large heterogeneous secondary lysosomes which are present in the intermediate and superficial cells of the normal bladder are reduced in number and the amount of rough endoplasmic reticulum is increased.The electron microscopic appearances of the urinary bladder epithelium of several mammalian species are well documented but there are few reports of similar studies in man. Fulker, Cooper, and Tanaka (1971) described the ultrastructure of human transitional cell carcinoma and commented on the appearance of the epithelium in the non-neoplastic areas, and Battifora, Eisenstein, and McDonald (1964) Materials and Methods CLINICALSpecimens of bladder mucosa were obtained from the trigone at the time of suprapubic urinary diversion in six boys aged 2-13 years (table I)

A Light and Electron Microscopic Study of Urothelium from Patients with Chronic Cystitis

“…Haynes et al [1975] examined urothe lium taken from children with urinary tract infections, correlating their light and transmission electron micro scopic observations with bacteriological findings. Some of their observations are similar to those seen here.…”

“…The biopsy procedure and the methods of tissue process ing from group A patients have been described by Smith [1981], those of groups Bi and B2 by Haynes et al [1975].…”

Ultrastructural Observations on Cystitis Cystica in Human Bladder Urothelium

“…There is considerable uncertainty about the aetiology, morphology and clinical significance of cystitis cystica in human bladder urothelium, where the occurrence of cysts has been documented for over a century (von Limbeck, 1887;Lubarsch, 1893;von Brunn, 1893). Cystitis cystica affects both sexes in children (Kaplan and King, 1970;Haynes et al, 1975;Vlatkovic et al, 1977;Belman, 1978) and adults (Parker, 1970;Mostofi and Davis, 1984). I t has occasionally been reported in animals (Frith, 1979;Zachary, 1981).…”