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Renal pelvis, enlarged upper end of the ureter, the tube through which urine flows from the kidney
to the urinary bladder. The pelvis, which is shaped somewhat like a funnel that is curved to one
side, is almost completely enclosed in the deep indentation on the concave side of the kidney, the
sinus. The large end of the pelvis has roughly cuplike extensions, called calyces, within the
kidney—these are cavities in which urine collects before it flows on into the urinary bladder.

Like the ureter, the renal pelvis is lined with a moist mucous-membrane layer that is only a few
cells thick; the membrane is attached to a thicker coating of smooth muscle fibres, which, in turn,
is surrounded by a layer of connective tissue. The mucous membrane of the pelvis is somewhat
folded so that there is some room for tissue expansion when urine distends the pelvis. The muscle
fibres are arranged in a longitudinal and a circular layer. Contractions of the muscle layers occur
in periodic waves known as peristaltic movements. The peristaltic waves help to push urine from
the pelvis into the ureter and bladder. The lining of the pelvis and of the ureter is impermeable to
the normal substances found in urine; thus, the walls of these structures do not absorb fluids.

What is the Renal Pelvis?

The renal pelvis is an important part of the kidney in humans and many animals that essentially
acts as a filter for urine before it passes out of the kidney and into the bladder. It looks sort of like
a cup-shaped open cavity, and it can usually expand or retract in response to urine volume. Its
main role is to regulate the amount of urine flowing to keep things more or less constant and to
avoid overwhelming the bladder or urinary tract. Some people have abnormally large or strangely
shaped cavities, and this doesn’t usually pose a problem. The area is commonly the site of cell
mutation, however, and this often is problematic. This cavity is where most kidney cancers start.
Tumors and cancerous growths here can be really dangerous, since they can block the flow of urine
and lead to infection, inflammation, and ultimately organ failure.

Location and Basic Anatomy

The human kidneys are two bean-shaped organs that are located near the middle of the back,
immediately below the rib cage. Kidneys perform the essential function of removing waste
products from the blood and regulating fluid levels. The waste and extra fluids become urine,
which drains into the pelvis. This cavity collects the urine before it is passed on to the urinary
bladder.

Generally, the renal pelvis is shaped like a funnel and collects urine from the thousands of nephrons
found in the kidney. Each kidney has one pelvis, and each consists of a network of intersecting
smooth muscle fibers. Smooth muscles are involuntary muscles, meaning that they cannot be
consciously controlled. The smooth muscle fibers are bound together into sheets or bundles by
reticular fibers and can be thought of as elastic fiber “nets” that are somewhat stretchable.

Looking at a cross-section of the cavity will usually reveal three distinct layers. The serosa is the
outer-most layer, and is a thick layer of tissue. Just below that is the muscle layer, which is the
bulk of the cavity. The muscle is what expands and contracts. This layer is lined with what is
known as mucosa, which is made mostly of transitional cells that act as insulation.

Main Function

There are two main jobs that this cavity performs: first, it collects the urine produced by the kidney;
then, it regulates the speed and timing with which that urine flows out into the bladder. Both are
important to proper organ functioning and both contribute to a healthy urinary tract. Funneling the
fluid in a controlled way puts less of a strain on the kidneys and the bladder, and also helps ensure
that the each kidney is working in tandem with the other.

Abnormalities and Defects

In some individuals, the cavity becomes enlarged and protrudes from the kidney. This isn’t normal,
but it isn’t usually a problem, either. The condition is called extra-renal pelvis in the medical
community, which basically means that it’s sticking out. Most of the time people who have this
condition don’t know it unless they are getting their kidneys imaged or have the organs exposed
during surgery, since they usually work just fine and the protrusion doesn’t typically impact the
cavity’s functioning.

Cancerous Growths

Most kidney cancers start in the renal pelvis, which makes the area one that medical professionals
often pay particular attention to during exams. Cancers here usually are carcinomas, which
basically means that they originate in smooth muscle epithelial cells. They typically start as small
cell growths on the mucosa walls that spread to the renal tubes. As they grow into tumors they can
block these tubes, or use them as vehicles to spread to the bladder, the stomach, and elsewhere in
the digestive tract. This type of cancer is usually somewhat rare. It is often very treatable, but a lot
of this depends on how early it was detected and how much it has spread.

What Causes a Dilated Renal Pelvis?

Hydronephrosis, a condition that occurs when urine does not drain from a kidney properly, is the
primary cause of a dilated renal pelvis. The renal pelvis is the area in the kidney where urine
collects before exiting via the ureter, and when the urine gets backed up, it becomes dilated. Infants
and adults are the main populations affected by this problem, which is typically the result of a
blockage or some other issue that constricts one or both of the ureters. In infants, the cause is
usually a congenital defect in the ureters, such as a narrowing of the tubes or a problem with the
valves that control urine drainage. For adults, a dilated renal pelvis can result from a number of
problems, including pressure from tumors or masses, structural problems within the kidney or
ureters, or malfunctions due to disease.

A dilated renal pelvis is fairly common in infants, who may be predisposed to genetic anomalies
within their urinary system. They may have one or both ureters that are narrower than normal at
the end closest to the kidney, which causes a blockage of the ureteropelvic junction, or UPJ.
Another common issue is that the valves that control the flow of urine through the ureters
malfunction, causing a reflux of urine back up into the kidneys.

Adults can develop a dilated renal pelvis, though it is less common than in infants, and it can
happen for many different reasons. While structural abnormalities can also lead to the condition,
it is more apt to occur as a result of other issues in an adult. One common problem is pressure on
the ureters, which causes them to narrow and obstruct the UPJ. This may be the result of nearby
masses, like tumors or an enlarged prostate, or from swelling in surrounding tissues due to
inflammation. Pregnant women frequently develop a dilated renal pelvis, as pressure from the
growing fetus can easily put pressure on the nearby ureters and kidneys.

Disease and other medical conditions may also lead to a dilated renal pelvis in adults. The ureters
can become blocked by blood clots, kidney stones, or uric acid crystals, obstructing some or all of
the urine draining from the kidneys. Diseases that cause inflammation of the urinary tract may be
to blame. People who have had surgery on their urinary tract also sometimes have issues afterward
with urine drainage from the kidneys.

What Is the Function of the Renal Pelvis?

The renal pelvis refers to the funneling area of the kidney responsible for urine collection. It is the
portion of the kidney where either two or three major calyces join. Major calyces are structures
that are part of an extensive drainage system within each kidney. Even though the renal pelvis is
where the flow of urine begins, urine has already gone through the processes of filtration and
reabsorption before it reaches this area. Although rare, tumors of the renal pelvis are a rare
neoplasmic condition of the upper portion of the urinary tract.

Encompassing the kidneys, urinary bladder, and their ducts, the human urinary system is generally
contained within the ventral abdominopelvic cavity. Located under the diaphragm in the mid-back
region lie the kidneys, which resemble two red beans. Each kidney is associated with a pair of
ureters and these lead directly into the bladder, as the urethra leads from the bladder to an external
opening on the outside of the body. Evidenced by women’s susceptibility to urinary infection, the
urethra is longer in males and considerably shorter in females.

By the time that concentrated urine reaches the renal pelvis, its condition has been significantly
changed. Useful substances have been returned to the blood by reabsorption, while wastes and
excess materials that entered by filtration or secretion have been retained. Concentrated urine is
mostly composed of water; the rest is nitrogenous waste and salts.

Urinary flow starts from within the renal pelvis of the kidney, into the ureters, into the bladder,
and out of the body via the urethra. As urine is produced, it moves from the collecting area, ducts
called the renal papilla, and into the renal pelvis. Urine flows into the paired ureters and on into
the urinary bladder where it is further collected. Capable of holding up to 2 cups (473 ml) of urine
at one time, the bladder then shrivels down to the size of a mid-sized nut after it has been emptied.
In rare instances, people develop tumors inside of the renal pelvis of the kidney. Characterized by
pain and blood in the urine, urothelial masses may alter urinary system structure and obstruct the
normal flow or urine. Smoking and high caffeine intake has been linked to cancer of the upper
urinary tract, particularly in men. Typical treatment of the disease depends on tumor staging,
although surgery and chemotherapy are usually the standard therapy for masses upwards of stage
two.