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Recent prospective, comparative ultrastructural/urodynamic studies on geriatric voiding dysfunction, including its natural evolution, have revealed that abnormalities of detrusor behavior have specific correlates in detrusor microstructure represented by distinctive electron-microscopic patterns. Each electron-microscopic pattern comprises a constellation of features in two or all three tissue compartments of the detrusor (smooth muscle, interstitium, intrinsic nerves). The pattern characteristic of each dysfunction is the same in detrusors of men and women. The electron-microscopic patterns are additive when multiple abnormalities coexist. All distinctive patterns of various clinical voiding dysfunctions can readily be defined qualitatively in endoscopic biopsies of the detrusor. These observations, including those on material studied for the natural evolution of geriatric voiding dysfunction, have led to the proposal of a clinical/structural definition of the normal aging detrusor and the development of an algorithm for pathologic diagnosis of geriatric voiding dysfunction.

A light- and electron-microscope investigation was performed to examine the normal structure of the porcine urinary bladder. Tissue biopsies were studied obtained from 10 healthy female pigs (four weanling pigs, six sows). The bladder wall showed a typical stratification consisting of a tunica (t.) mucosae, t. submucosae, t. muscularis and t. serosa. The mucosa consisted of an epithelium transitionale, a lamina propria, and a lamina muscularis mucosae. The urothelium was composed of a basal layer, one or more intermediate layer(s), and a superficial layer. The urothelial cells of all layers were connected by desmosomes, while tight junctions linked adjacent superficial cells. Surface cells were lined by a layer of mucus, which is believed to provide an important barrier against bacterial infection. The surface of the superficial cells was also characterized by numerous irregularly arranged microplicae. By contrast, intermediate cells, which are assumed to be immature cell forms, showed microvilli-like structures. When desquamation of superficial cells takes place, differentiation of underlying intermediate cells is accompanied by merging of microvilli to form microplicae. The morphology of the bladder surface structures may play an important role in the ability of bacteria to adhere to the urothelium.

Scanning electron microscopy was performed on bladder biopsies from 20 sows with cystitis. Results were compared with those of healthy control animals. Biopsy specimens were taken from nine sows infected only with commensal bacteria (E. coli, streptococci, staphylococci) and from 11 sows, where Eubacterium suis (E. suis) was involved in urinary tract infection and had caused a haemorrhagic cystitis. Increased losses of normal superficial cells covered with microplicae could be seen depending on the degree of cystitis. Desquamation of the surface layer exposed smaller cells patterned with short microvilli. These cells were presumed to be immature intermediate cells and goblet cells. Goblet cells were found only in infected organs. The varying surface structure of epithelial cells in relation to receptor quality is important for the bacterial adherence to bladder mucosa. All examined bladders infected with E. suis showed a total loss of superficial cells. Luminal cells covered with multiple short microvilli were accompanied by cells with long pleomorphic processes. Accumulating cell necrosis was indicated by a smooth surface structure. Funnel-shaped orifices between the epithelial cells were identified as excretory ducts of mucus-filled cysts, which are formed by the confluence of degenerating goblet cells. E. suis infection of the porcine bladder causes more severe alterations than infections due to other bacteria. However, debilitation of the urothelium due to previous infection is necessary to support infection of the bladder with E. suis.

Von Brunn's nests have been investigated systematically by means of histology and autoradiography in 201 biopsies of tumour-free and tumorous urinary bladders. They show the same proliferation behaviour like the superimposed urothelium under normal conditions and with inflammatory, metaplastic and dysplastic changes. Their sheltered location permits definite diagnoses even with detached superficial urothelium. In case of cystic transformation, a distinction between pseudoglandular, pseudopapillary and cribriform types is possible. They have to be distinguished from genuine glandular metaplasias in von Brunn's nests. Normal and metaplastic von Brunn's nests do not represent precancerous stages. They are supposed to be a protected proliferation reserve.

There exist 2 characterization levels: karyometry and histometry. The state of the art in karyometry is relatively wide advanced. A wide spectrum of methods exists and there is often a good correlation between measured parameters and diagnosis as well as prognosis. The development of histometry is just in the first phase. This paper gives an introduction to the histometrical methods based on the AMBA/R-software-system.

The frequency of sex chromatine occurring in cell nuclei of twelve organs from 25 male and female corpses was determined using the smear method. It was found to be about 60% in the case of female, and about 6% in the case of male corpses.