Journal of the Medical Association of Thailand Vol 94, No 10:OCTOBER 2011 0125-2208 94 10 2011 Oct Ultrastructural Study of The Detrusor in End Stage Renal Disease 1218 EN Premsant Sangkum Panas Charermsanyakorn Kittinut Kijvikai Wisoot Kongcharoensombat Wachira Kochakarn Original Article To study ultrastructural changes of detrusor muscle in the specific group of patients with end stage renal disease. Detrusor biopsy of 20 patients, including 15 in end stage renal disease and five in patients with normalcreatinine, was obtained by open technique. Biopsy was done during ureteral reimplantation at the time of kidney transplantation.In normal renal function group, detrusor biopsy was done at the time of open bladder surgery from other urologic diseases.The specimens were processed for light microscopy and transmission electron microscopy using standard techniques. All specimens from open biopsy provided sufficient quality to be examined by electron microscope. The averagecreatinine level was 9.2 and 1.0 mg/dl in the ESRD group and control group, respectively. In the ESRD group, all showedhypertrophy of muscle bundles, fibrosis between muscle bundles, muscle bundle degeneration, and fragmentation of musclecells. In ESRD group, 93% had fibrosis around nerve bundles and enlarged muscle cell nuclei. About 60% had enlargednerve bundles, and 53% showed amorphous inclusion in muscle cells. The ESRD group displayed many more ultrastructuralchanges than in the control group and some appearances were not present in the control group. There were distinct ultrastructural changes of detrusor muscles in ESRD patients. These ultrastructuralchanges of detrusor muscles may be associated with voiding dysfunction after kidney transplantation. Detrusor Ultrastructural End stage renal disease