Urorectal septum

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Urorectal septum
Gray992.png
Cloaca of human embryo from twenty-five to twenty-seven days old.
Details
Days32
Precursor cloaca
System genitourinary system
Identifiers
Latin septum urorectale
TE septum_by_E5.4.9.0.2.0.14 E5.4.9.0.2.0.14
Anatomical terminology

The urorectal septum is an invagination of the cloaca. It divides it into a dorsal part (the hindgut) and a ventral part (the urogenital sinus). It invaginates from cranial to caudal, formed from the endodermal cloaca, and fuses with the cloacal membrane. Malformations can cause fistulas.

Contents

Structure

The urorectal septum is an embryonic structure formed from an invagination of the cloaca. The urorectal septum divides the cloaca into two parts:

The urorectal septum becomes part of the perineal body, helping to form the perineum. [1]

Development

The urorectal septum develops from cranial to caudal, and is flat in the coronal plane. [1] It is formed from endoderm, the same germ layer as the cloaca. It fuses with the cloacal membrane.

Clinical significance

Urorectal septum malformation

Malformation of the urorectal septum can lead to several different types of fistulas. [2] [3]

Classification

In women, at least five different types of fistula are possible. [3] All of these involve the fusion of the urogenital sinus and the end of the hindgut, causing the rectum to end in the vagina. [3] This may be associated with the uterus in the normal position, posterior to the hindgut, or bicornuate. [3]

In men, at least three different types of fistula are possible. [3] The hindgut may enter and preserve the urogenital sinus after birth. [3] The hindgut may replace the urogenital sinus completely, in which case it may also replace the urinary bladder and cause the ureters to drain into it. [3]

Prognosis

Urorectal septum malformation is associated with a number of other birth defects, including spina bifida, deafness, sacral hypoplasia, atrial septal defect, ventricular septal defect, tetralogy of Fallot, and limb musculoskeletal disorders. [3] Mainly because of these associations, up to 20% of children born with urorectal septum malformation may not survive long-term. [3] Outcomes from corrective surgery on a urorectal septum fistula are very good. [3]

Related Research Articles

<span class="mw-page-title-main">Urethra</span> Tube that connects the urinary bladder to the external urethral orifice

The urethra is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra connects to the urinary meatus above the vagina, whereas in marsupials, the female's urethra empties into the urogenital sinus.

<span class="mw-page-title-main">Bladder</span> Organ in humans and vertebrates that collects and stores urine from the kidneys before disposal

The bladder is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters the bladder via the ureters and exits via the urethra. The typical adult human bladder will hold between 300 and 500 ml before the urge to empty occurs, but can hold considerably more.

<span class="mw-page-title-main">Seminal vesicles</span> Pair of simple tubular glands posteroinferior to the urinary bladder of male mammals

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<span class="mw-page-title-main">Urogenital sinus</span> A part of the human body only present in the development of the urinary and reproductive organs

The urogenital sinus is a part of the human body only present in the development of the urinary and reproductive organs. It is the ventral part of the cloaca, formed after the cloaca separates from the anal canal during the fourth to seventh weeks of development.

<span class="mw-page-title-main">Paramesonephric duct</span> Paired ducts in the embryo in the primitive urogenital structures

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The development of the urinary system begins during prenatal development, and relates to the development of the urogenital system – both the organs of the urinary system and the sex organs of the reproductive system. The development continues as a part of sexual differentiation.

<span class="mw-page-title-main">Imperforate anus</span> Birth defect of malformed rectum

An imperforate anus or anorectal malformations (ARMs) are birth defects in which the rectum is malformed. ARMs are a spectrum of different congenital anomalies which vary from fairly minor lesions to complex anomalies. The cause of ARMs is unknown; the genetic basis of these anomalies is very complex because of their anatomical variability. In 8% of patients, genetic factors are clearly associated with ARMs. Anorectal malformation in Currarino syndrome represents the only association for which the gene HLXB9 has been identified.

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<span class="mw-page-title-main">Foregut</span> Anterior part of the gastrointestinal tract

The foregut in humans is the anterior part of the alimentary canal, from the distal esophagus to the first half of the duodenum, at the entrance of the bile duct. Beyond the stomach, the foregut is attached to the abdominal walls by mesentery. The foregut arises from the endoderm, developing from the folding primitive gut, and is developmentally distinct from the midgut and hindgut. Although the term “foregut” is typically used in reference to the anterior section of the primitive gut, components of the adult gut can also be described with this designation. Pain in the epigastric region, just below the intersection of the ribs, typically refers to structures in the adult foregut.

<span class="mw-page-title-main">Cloacal membrane</span>

The cloacal membrane is the membrane that covers the embryonic cloaca during the development of the urinary and reproductive organs.

<span class="mw-page-title-main">Urachus</span>

The urachus is a fibrous remnant of the allantois, a canal that drains the urinary bladder of the fetus that joins and runs within the umbilical cord. The fibrous remnant lies in the space of Retzius, between the transverse fascia anteriorly and the peritoneum posteriorly.

<span class="mw-page-title-main">Aorticopulmonary septum</span>

The aorticopulmonary septum is developmentally formed from neural crest, specifically the cardiac neural crest, and actively separates the aorta and pulmonary arteries and fuses with the interventricular septum within the heart during heart development.

<span class="mw-page-title-main">Cloaca (embryology)</span> Structure in the embryo

The cloaca is a structure in the development of the urinary and reproductive organs.

<span class="mw-page-title-main">Human embryonic development</span> Development and formation of the human embryo

Human embryonic development, or human embryogenesis, is the development and formation of the human embryo. It is characterised by the processes of cell division and cellular differentiation of the embryo that occurs during the early stages of development. In biological terms, the development of the human body entails growth from a one-celled zygote to an adult human being. Fertilization occurs when the sperm cell successfully enters and fuses with an egg cell (ovum). The genetic material of the sperm and egg then combine to form the single cell zygote and the germinal stage of development commences. Embryonic development in the human, covers the first eight weeks of development; at the beginning of the ninth week the embryo is termed a fetus. The eight weeks has 23 stages.

The development of the reproductive system is the part of embryonic growth that results in the sex organs and contributes to sexual differentiation. Due to its large overlap with development of the urinary system, the two systems are typically described together as the urogenital or genitourinary system.

<span class="mw-page-title-main">Diphallia</span> Genital medical condition

Diphallia, penile duplication (PD), diphallic terata, or diphallasparatus, is an extremely rare developmental abnormality in which a male is born with two penises. The first reported case was by Johannes Jacob Wecker in 1609. Its occurrence is 1 in 5.5 million boys in the United States.

The development of the digestive system in the human embryo concerns the epithelium of the digestive system and the parenchyma of its derivatives, which originate from the endoderm. Connective tissue, muscular components, and peritoneal components originate in the mesoderm. Different regions of the gut tube such as the esophagus, stomach, duodenum, etc. are specified by a retinoic acid gradient that causes transcription factors unique to each region to be expressed. Differentiation of the gut and its derivatives depends upon reciprocal interactions between the gut endoderm and its surrounding mesoderm. Hox genes in the mesoderm are induced by a Hedgehog signaling pathway secreted by gut endoderm and regulate the craniocaudal organization of the gut and its derivatives. The gut system extends from the oropharyngeal membrane to the cloacal membrane and is divided into the foregut, midgut, and hindgut.

<span class="mw-page-title-main">Vaginal anomalies</span> Congenital defect; abnormal or absent vagina

Vaginal anomalies are abnormal structures that are formed during the prenatal development of the female reproductive system and are rare congenital defects that result in an abnormal or absent vagina.

Caudal duplication, is a rare congenital disorder in which various structures of the caudal region, embryonic cloaca, and neural tube exhibit a spectrum of abnormalities such as duplication and malformations. The exact causes of the condition is unknown, though there are several theories implicating abnormal embryological development as a cause for the condition. Diagnosis is often made during prenatal development of the second trimester through anomaly scans or immediately after birth. However, rare cases of adulthood diagnosis has also been observed. Treatment is often required to correct such abnormalities according to the range of symptoms present, whilst treatment options vary from conservative expectant management to resection of caudal tissue to restore normal function or appearance. As a rare congenital disorder, the prevalence at birth is less than 1 per 100,000 with less than 100 cases reported worldwide.

References

PD-icon.svgThis article incorporates text in the public domain from page 1109 of the 20th edition of Gray's Anatomy (1918)

  1. 1 2 3 4 Hynes, Pat J.; Fraher, John P. (January 2004). "The development of the male genitourinary system. I. The origin of the urorectal septum and the formation of the perineum". British Journal of Plastic Surgery. 57 (1): 27–36. doi:10.1016/j.bjps.2003.08.019. ISSN   0007-1226. PMID   14672675 via ScienceDirect.{{cite journal}}: CS1 maint: date and year (link)
  2. Escobar LF, Heiman M, Zimmer D, Careskey H (2007). "Urorectal septum malformation sequence: Prenatal progression, clinical report, and embryology review". Am. J. Med. Genet. A. 143 (22): 2722–6. doi:10.1002/ajmg.a.31925. PMID   17937427. S2CID   19219635.
  3. 1 2 3 4 5 6 7 8 9 10 Wheeler, Patricia G.; Weaver, David D. (2001). "Partial urorectal septum malformation sequence: A report of 25 cases". American Journal of Medical Genetics. 103 (2): 99–105. doi: 10.1002/ajmg.1510 . ISSN   1096-8628. PMID   11568914.