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Embriologia do Trato Urinário II

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Embriologia do Trato Urinário II

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Embriologia do Trato Urinário II

  1. 1. EMBRIOLOGIA DO TRATO GENITOURINÁRIO II Serviço de Urologia Hospital das Clínicas – HC – UFG Rodrigo Pastor
  2. 2. Introdução <ul><li>Trato urinário inferior </li></ul><ul><li>Sistema Genital </li></ul>
  3. 3. Formação da Bexiga <ul><li>4 ª a 7 ª semana de desenvolvimento </li></ul><ul><li>Resultado da divisão da cloaca pelo septo urogenital </li></ul><ul><li>Duas fontes: </li></ul><ul><ul><li>Parte vesical do seio urogenital </li></ul></ul><ul><ul><li>Ducto mesonéfrico (trígono vesical) </li></ul></ul>
  4. 4. Formação da Bexiga Campbell’s Urology – 9 th Edition
  5. 5. Formação da Bexiga Campbell’s Urology – 9 th Edition
  6. 6. Formação da Bexiga Langman's Medical Embryology - 10th Edition
  7. 7. Formação da Bexiga Langman's Medical Embryology - 10th Edition
  8. 8. Formação da Próstata Langman's Medical Embryology - 10th Edition
  9. 9. Anomalias do Úraco Langman's Medical Embryology - 10th Edition
  10. 10. Complexo Extrofia – Epispádia <ul><li>Presente em 1: 10000 a 1: 50000 nascimentos </li></ul><ul><li>( Homens 3:1) </li></ul><ul><li>Pode variar desde epispádia isolada até anomalias multisistêmicas (extrofia de cloaca) </li></ul><ul><li>Falha na migração do mesoderma da membrana cloacal </li></ul><ul><li>Anomalias associadas em trato genital, ossos da pelve, reto e ânus </li></ul>
  11. 11. Complexo Extrofia – Epispádia Campbell’s Urology – 9 th Edition
  12. 12. Complexo Extrofia – Epispádia Campbell’s Urology – 9 th Edition
  13. 13. Complexo Extrofia – Epispádia Langman's Medical Embryology - 10th Edition
  14. 14. Complexo Extrofia – Epispádia
  15. 15. Complexo Extrofia – Epispádia
  16. 16. Complexo Extrofia – Epispádia
  17. 17. SISTEMA GENITAL
  18. 18. Sistema Genital <ul><ul><li>Período de organogênese: </li></ul></ul><ul><ul><ul><li>Genitais internos -> 4 a 8 semanas </li></ul></ul></ul><ul><ul><ul><li>Genitais externos -> 6 a 12 semanas </li></ul></ul></ul>
  19. 19. Formação das Gônadas <ul><li>4 ª semana: </li></ul><ul><ul><li>Migração das células germinativas primordiais </li></ul></ul><ul><ul><li>Desenvolvimento da crista gonadal </li></ul></ul><ul><ul><li>Formação dos cordões sexuais primitivos </li></ul></ul><ul><li>Estágio indiferenciado </li></ul>
  20. 20. Formação das Gônadas Campbell’s Urology – 9 th Edition
  21. 21. Formação das Gônadas Langman's Medical Embryology - 10th Edition
  22. 22. Formação das Gônadas
  23. 23. Formação das Gônadas
  24. 24. Formação das Gônadas Langman's Medical Embryology - 10th Edition
  25. 25. Formação das Gônadas Langman's Medical Embryology - 10th Edition
  26. 26. Formação das Gônadas Langman's Medical Embryology - 10th Edition
  27. 27. Formação das Gônadas Langman's Medical Embryology - 10th Edition
  28. 28. Formação dos Ductos Genitais Langman's Medical Embryology - 10th Edition
  29. 29. Formação dos Ductos Genitais Campbell’s Urology – 9 th Edition
  30. 30. Formação dos Ductos Genitais Langman's Medical Embryology - 10th Edition
  31. 31. Descida dos Testículos Langman's Medical Embryology - 10th Edition
  32. 32. Descida dos Testículos Langman's Medical Embryology - 10th Edition
  33. 33. Langman's Medical Embryology - 10th Edition
  34. 34. Anomalias da descida dos testículos
  35. 35. Criptorquidia <ul><li>Descida incompleta do testículo para bolsa escrotal </li></ul><ul><li>3: 100 nascidos vivos </li></ul><ul><ul><li>30% em prematuros </li></ul></ul><ul><ul><li>3 a 4% dos nascidos a termo </li></ul></ul><ul><li>Pode ser uni ou bilateral </li></ul><ul><li>Maioria completa a descida no primeiro ano </li></ul>
  36. 36. Criptorquidia <ul><li>Podem estar localizados em qualquer local do trajeto de descida </li></ul><ul><li>Localização mais comum: canal inguinal </li></ul><ul><li>Deficiência de andrógenos constitui fator importante </li></ul><ul><li>anomalias no epidídimo em 90% dos casos </li></ul>
  37. 37. Criptorquidia
  38. 38. Aparelho Genital Feminino Campbell’s Urology – 9 th Edition
  39. 39. Aparelho Genital Feminino
  40. 40. Formação da Genitália Externa Campbell’s Urology – 9 th Edition
  41. 41. Formação da Genitália Externa Campbell’s Urology – 9 th Edition
  42. 42. Formação da Genitália Externa Campbell’s Urology – 9 th Edition Mulheres: Tubérculo Genital (Clitóris) Protuberâncias Genitais (Grandes lábios) Dobras Urogenitais (pequenos lábios)
  43. 43. Formação da Genitália Externa Campbell’s Urology – 9 th Edition
  44. 44. Formação da Genitália Externa
  45. 45. Formação da Genitália Externa Campbell’s Urology – 9 th Edition Homens: Protuberâncias Genitais: Bolsa Escrotal Dobras Urogenitais: Corpo do Pênis e a uretra peniana Tubérculo Genital: Glande do Pênis Seio Urogenital: Próstata
  46. 46. Formação da Genitália Externa Campbell’s Urology – 9 th Edition
  47. 47. Formação da Genitália Externa
  48. 48. Formação da Genitália Externa Campbell’s Urology – 9 th Edition
  49. 49. Formação da Genitália Externa Langman's Medical Embryology - 10th Edition
  50. 50. Hipospádia <ul><li>Defeito congênito da genitália externa masculina </li></ul><ul><li>1 : 250 nascimentos </li></ul><ul><li>Associação de três anomalias: </li></ul><ul><ul><li>Abertura ventral anômala do meato uretral (sempre presente) </li></ul></ul><ul><ul><li>Curvatura ventral anormal do pênis (“Chordee”) </li></ul></ul><ul><ul><li>Distribuição anormal do prepúcio </li></ul></ul>
  51. 51. Hipospádia Campbell’s Urology – 9 th Edition
  52. 52. Hipospádia Campbell’s Urology 9 th Edition -> 50% -> 30% -> 20%
  53. 53. Hipospádia <ul><li>Anomalias associadas: </li></ul><ul><ul><li>Criptorquidia (+ comum em hipospádias posteriores) </li></ul></ul><ul><ul><li>Hérnia inguinal </li></ul></ul><ul><ul><li>Hidrocele </li></ul></ul><ul><ul><li>Condições intersexo </li></ul></ul><ul><li>Hipospádia posterior -> Pesquisar condições intersexo </li></ul>
  54. 54. Condições intersexo <ul><li>Diferenciação sexual anormal </li></ul><ul><li>Classificação de acordo com o aspecto histológico das gônadas </li></ul><ul><li>Podem ou não estar associados a genitália ambígua </li></ul><ul><li>Intersexo XY (Síndrome da Insensibilidade ao Andrógeno) </li></ul><ul><li>intersexual XX (hiperplasia adrenal congênita) </li></ul>
  55. 55. Condições intersexo <ul><li>Desordens da diferenciação gonadal </li></ul><ul><li>Pseudo-hermafroditismo feminino </li></ul><ul><li>Pseudo-hermafroditismo masculino </li></ul><ul><li>Formas não classificadas </li></ul><ul><ul><li>Micropênis </li></ul></ul><ul><ul><li>Síndrome de Mayer-Rokitansky-Kuster-Hauser ( Agenesia Vaginal ou Mulleriana) </li></ul></ul>
  56. 56. Condições intersexo
  57. 57. Condições intersexo

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