Forms of Papilla (VUR)

Drawing of two forms of papilla. In the papilla on the right side all collecting channels have an oblique orifice in relation to the surface; on the left side the central collecting channels enter the papilla directly and perpendicularly to the surface (Ransley PG, Risdon RA. Br J Radiol Suppl 14:1-35, 1978). The papilla in the drawing on the left side enables an intrarenal reflux together with an already existing vesicoureteral reflux. The reflux of infected urine and/or of urine under pressure may lead to reflux nephropathy with consecutive scars, renal shrinkage, renal insufficiency, and renal hypertension.