Role of ureter in pathogenesis of ascending pyelonephritis.

Abstract

It is suggested that the ureter has a dual role in the pathogenesis of most cases of ascending pyelonephritis. Anatomically the ureter provides a direct route of invasion from bladder to kidney because the subepithelial tissues of the bladder, ureter, and renal pelvis are continuous with the interstitial tissue of the kidney. Physiologically the diseased ureter increases the susceptibility of the kidney to infection because ureteral dysfunction generally involves both obstruction and vesicoureteral reflux. The ureter is not an inert tube but an active muscular structure, and recognition of this fact leads to a dynamic, rather than a static, concept of ascending pyelonephritis.