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Genitourinary System Final

Genitourinary System Final

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Renal system Function:
Production of Urine
Excretion of Metabolic waste
Retention of needed fluid and
electrolytes
Regulation of Blood Pressure

Kidneys
are located peritoneally on the posterior
wall of the abdomen, its weighs 120-
170grms, 10-12cm long, 6 cm wide and
2.5 cm thick.
Ureter
are the thick, long 'tubes' that aid the urine
in moving from the kidneys to the bladder.
They are about 10 to 12 inches in length
and the urine moves downward by gravity
and peristalsis (waves of contractions). The
ureters enter the urinary bladder at an angle
to help prevent any back flow (reflux) of
urine back into the ureter.
Bladder
Urinary bladder functions as a
temporary reservoir for urine. The
bladder possesses features that
enable urine to enter, be stored,
and later be released for evacuation
from the body

Some disorders of the urinary
system

Benign prostatic hyperpIasia (BPH) is
a condition in men that affects the
prostate gland, which is part of the male
reproductive system. The prostate is
located at the bottom of the bladder and
surrounds the urethra. BPH is an
enlargement of the prostate gland that
can interfere with urinary function in
older men. Ìt causes blockage by
squeezing the urethra, which can make
it difficult to urinate. Men with BPH
frequently have other bladder symptoms
including an increase in frequency of
bladder emptying both during the day
and at night. Most men over age 60
have some BPH, but not all have
problems with blockage. There are
many different treatment options for
BPH.
PainfuI bIadder syndrome/InterstitiaI
cystitis (PBS/IC) is a chronic bladder
disorder also known as frequency-
urgency-dysuria syndrome. Ìn this
disorder, the bladder wall can become
inflamed and irritated. The inflammation
can lead to scarring and stiffening of the
bladder, decreased bladder capacity,
pinpoint bleeding, and, in rare cases,
ulcers in the bladder lining. The cause of
ÌC is unknown at this time.
Kidney stones is the term commonly
used to refer to stones, or calculi, in the
urinary system. Stones form in the
kidneys and may be found anywhere in
the urinary system. They vary in size.
Some stones cause great pain while
others cause very little. The aim of
treatment is to remove the stones,
prevent infection, and prevent
recurrence. Both nonsurgical and
surgical treatments are used. Kidney
stones affect men more often than
women.
Prostatitis is inflammation of the
prostate gland that results in urinary
frequency and urgency, burning or
painful urination, a condition called
dysuria, and pain in the lower back and
genital area, among other symptoms. Ìn
some cases, prostatitis is caused by
bacterial infection and can be treated
with antibiotics. But the more common
forms of prostatitis are not associated
with any known infecting organism.
Antibiotics are often ineffective in
treating the nonbacterial forms of
prostatitis.
Proteinuria is the presence of abnormal
amounts of protein in the urine. Healthy
kidneys take wastes out of the blood but
leave in protein. Protein in the urine
does not cause a problem by itself. But
it may be a sign that your kidneys are
not working properly.
RenaI (kidney) faiIure results when the
kidneys are not able to regulate water
and chemicals in the body or remove
waste products from your blood. Acute
renal failure (ARF) is the sudden onset
of kidney failure. This condition can be
caused by an accident that injures the
kidneys, loss of a lot of blood, or some
drugs or poisons. ARF may lead to
permanent loss of kidney function. But if
the kidneys are not seriously damaged,
they may recover. Chronic kidney
disease (CKD) is the gradual reduction
of kidney function that may lead to
permanent kidney failure, or end-stage
renal disease (ESRD). You may go
several years without knowing you have
CKD.
Urinary tract infections (UTIs) are
caused by bacteria in the urinary tract.
Women get UTÌs more often than men.
UTÌs are treated with antibiotics.
Drinking lots of fluids also helps by
flushing out the bacteria.
The name of the UTÌ depends on its
location in the urinary tract. An infection
in the bladder is called cystitis. Ìf the
infection is in one or both of the kidneys,
the infection is called pyelonephritis.
This type of UTÌ can cause serious
damage to the kidneys if it is not
adequately treated.
Urinary incontinence, loss of bladder
control, is the involuntary passage of
urine. There are many causes and types
of incontinence, and many treatment
options. Treatments range from simple
exercises to surgery. Women are
affected by urinary incontinence more
often than men.
Urinary retention, or bladder-emptying
problems, is a common urological
problem with many possible causes.
Normally, urination can be initiated
voluntarily and the bladder empties
completely. Urinary retention is the
abnormal holding of urine in the bladder.
Acute urinary retention is the sudden
inability to urinate, causing pain and
discomfort. Causes can include an
obstruction in the urinary system, stress,
or neurologic problems. Chronic urinary
retention refers to the persistent
presence of urine left in the bladder after
incomplete emptying. Common causes
of chronic urinary retention are bladder
muscle failure, nerve damage, or
obstructions in the urinary tract.
Treatment for urinary retention depends
on the cause.

Urethritis
is inflammation of the urethra from any
cause.
Chronic RenaI FaiIure (CRF)
Chronic kidney disease is the slow loss of
kidney function over time. The main function
of the kidneys is to remove
Chronic RenaI FaiIure (CRF)
Chronic kidney disease is the slow loss of
kidney function over time. The main function
of the kidneys is to remove...
Acute TubuIar Necrosis (ATN)
Acute tubular necrosis is a kidney disorder
involving damage to the tubule cells of the
kidneys, resulting in acute...
Diabetic Nephropathy
Diabetic nephropathy is kidney disease or
damage that results as a complication of
diabetes. See also: Type 1 diabetes
Membranous GIomeruIonephritis
Membranous nephropathy is a kidney
disorder which involves changes and
inflammation of the structures inside the
kidney...
Goodpasture Syndrome
Goodpasture syndrome is a rare disease
that can involve rapidly progressive kidney
failure along with lung disease...

HepatorenaI Syndrome
Hepatorenal syndrome is a condition in
which the kidneys fail suddenly in a person
with cirrhosis of the liver

Hydronephrosis
Unilateral hydronephrosis is swelling of one
kidney due to a backup of urine. See also:
Bilateral hydronephrosis
PyeIonephritis
Pyelonephritis is an inflammation of the
kidney and upper urinary tract that usually
results from noncontagious...
UreteraI Obstruction
Acute unilateral is a sudden blockage in one
of the tubes (ureters) that drain urine from
the kidneys.
UrethraI Stricture
Urethral stricture is an abnormal narrowing
of the tube that carries urine out of the body
from the bladder (urethra.
Lupus Nephritis
Lupus nephritis is a kidney disorder that is a
complication of systemic lupus
erythematosus.
Urinary Tract Obstruction
Obstructive uropathy is a condition in which
the flow of urine is blocked, causing it to
back up and injure one or both.
Kidney Infections
Kidney infection is a general term used to
describe infection of the kidney by bacteria,
fungi, or viruses
Nephrogenic Diabetes Insipidus
Nephrogenic diabetes insipidus is a disorder
in which a defect in the small tubes
(tubules) in the kidneys
End Stage RenaI Disease (ESRD)
End-stage kidney disease is the complete or
almost complete failure of the kidneys to
function
Hypertensive RenaI Disease
Renal failure (kidney failure) is caused
primarily by chronic high blood pressure
(hypertension) over many years.
GIomeruIonephritis
Glomerulonephritis is a type of kidney
disease in which the part of your kidneys
that helps filter waste and fluids from...


Cystoscopy
examintation of the bladder using a rigid or
flexible cystoscope
Kidney biopsy (Bx),
renal biopsy
removal of kidney tissue for pathologic
examination
Radiography x-ray studies commonly used in urology
Ìntravenous pyelogram
(ÌVP), intravenous
urogram
x-rays of the urinary tract taken after an iodine
contrast medium is injected into the bloodstream;
the contrast passes through the kidney and may
reveal an obstruction, evidence of trauma, and so
on
Kidney, ureter, bladder
(KUB)
abdominal x-ray of kidney, ureter, and bladder
typically used as a scout film before doing an ÌVP
Scout film
plain x-ray take to detect any obvious pathology
before further imaging (e.g., a KUB before an
ÌVP)
Renal angiogram
(arteriogram)
x-ray of the renal artery made after injecting
contrast material into a catheter in the artery
Retrograde pyelogram
(RP)
x-ray of the ureters, bladder, and kidney taken
after contrast medium is administered backward
through a small catheter through a cystoscope to
detect the presence of stones, obstruction, and
so on
Voiding (urinating)
cystourethrogram
(VCU) or (VCUG)
x-ray of the bladder and urethra taken during
urination
Abdominal sonogram
ultrasound image of the urinary tract, including
the kidney and bladder
Urinalysis (UA)
physical, chemical, and microscopic examination
of urine
Specific gravity (SpGr) measure of the concentration or dilution of urine
pH measure of the acidity or alkalinity of urine
Glucose (sugar)
chemical test used to detect sugar in the urine;
used most oftern to screen for diabetes
Albumin (alb) protein
chemical test used to detect the presence of
albumin in the urine
Ketones
chemical test used to detect the presence of
ketone bodies in the urine; positive test indicates
fats are being used by the body instead of
carbohydrates, which occurs in starvation or in an
uncontrolled diabetic state
Occult blood, urine
chemical test for the presence of hidden blood in
the urine resulting from red blood cell hemolysis;
indicates bleeding in the kidneys (occult =
hidden)
Bilirubin
chemical test used to detect bilirubin in the urine;
seen in gallbladder and liver disease
Urobilinogen
chemical test used to detect bile pigment in the
urine - increased amounts seen in gallbladder
and liver disease
Nitrite
chemical test to determine the presence of
bacteria in the urine
Microscopic findings
microscopic identification of abnormal
constituents present in the urine (e.g., red blood
cells, white blood cells, and casts); reported per
high or low power field (hpf or lpf)
Urine culture and
sensitivity (C&S)
isolation of a urine specimen in a culture medium
to propagate the growth of microorganisms;
organisms that grow in the culture are identtified
along with drugs to which they are sensitive
Blood ures nitrogen
(BUN)
blood test to determine the level of urea in the
blood; a high BUN indicates the kidney's inability
to excrete urea

5 TYPES OF HERNÌATÌON ÌN
FEMALE

URETROCELE
Bulging of anterior wall in the urethra
CystoceIe
Herniation of blader wall into vaginal
outlet
EnteroceIe
Bowel into the posterior vaginal vault
PeIvic proIapsed
Bulging of cervix into vagina
RectoceIe
Herniation of rectum in vaginal wall
Stress incontinence
People with stress incontinence
involuntarily leak urine while exercising,
coughing, sneezing, laughing or lifting.
During these activities, sudden pressure
to the bladder causes urine to leak.
Stress incontinence is the most common
type of incontinence among women. Ìt
may be due to weakened pelvic
muscles, weakening in the wall between
the bladder and vagina, or a change in
the position of the bladder. Ìn many
cases, the condition develops as a
result of pregnancy and childbirth. Other
causes of stress incontinence include:
O Weakening of muscles that hold the
bladder in place, or weakening of the
bladder itself
O Weakening of the urethral sphincter
muscles
O Damage to the nerves controlling the
bladder from diseases such as
diabetes, stroke, Parkinson's
disease and/or multiple sclerosis, or
from treatment of gynecologic or
pelvic cancers with surgery, radiation
or chemotherapy
O Ìn women, a hormone imbalance or
a decrease in estrogen following
menopause, which can weaken the
sphincter muscle
O Ìn men, benign prostatic hyperplasia
(a noncancerous overgrowth of the
prostate gland), prostate cancer or
prostate surgery
Urge incontinence
Problems caused by oversensitive
bladder.
A frequent, sudden urge to urinate along
with little control of the bladder
(especially when sleeping, drinking, or
listening to running water) is known as
urge incontinence. This condition is also
known as spastic bladder, overactive
bladder or reflex incontinence. Urge
incontinence is marked by a need to
urinate more than seven times daily or
more than twice nightly. Ìt is most
common in older adults. Ìt also may be a
symptom of a urinary infection in the
bladder or kidneys, or may result from
injury, illness or surgery. Among the
possible causes are:
O Stroke
O Diseases of the nervous system,
such as multiple sclerosis,
Alzheimer's or Parkinson's
O Tumors or cancer in the uterus,
bladder or prostate
O Ìnterstitial cystitis (inflamed bladder
wall)
O Prostatitis (inflamed prostate)
O Prostate removal, cesarean
section, hysterectomy, or surgery
involving the lower intestine or
rectum
OverfIow incontinence

Bladder doesn't empty completely,
leading to frequent urination or dribbling.
People with overflow incontinence
cannot completely empty their bladders.
A constantly full bladder triggers
frequent urination or a constant dribbling
of urine, or both. This type of
incontinence is often caused by bladder
muscles weakened as a result of nerve
damage from diabetes or other
diseases. Ìt can also occur when the
urethra is blocked due to kidney or
urinary stones, tumors, an enlarged
prostate in men, female bladder surgery
that is too tight, or a birth defect.
FunctionaI incontinence
Functional incontinence is the most
common type among older adults with
arthritis, Parkinson's disease or
Alzheimer's disease. These people are
often unable to control their bladder
before reaching the bathroom due to
limitations in moving, thinking or
communicating.
Mixed incontinence
Some people experience two types of
incontinence simultaneously, typically
stress incontinence and urge
incontinence. Mixed incontinence is
most commonly found in women. What
causes the two forms may or may not
be related.
Anatomic or deveIopmentaI
abnormaIities
Ìncontinence is sometimes caused by
an anatomic (physical) or neurologic
abnormality. An abnormal opening
between the bladder and another
structure (called a fistula) can cause
incontinence, as can a leak in the
urinary system.
Loss of normal bladder function may
also result from damage to part of the
nervous system due to trauma, disease
or injury. This dysfunction, called
neurogenic bladder, can cause the
bladder to be underactive (unable to
contract and empty completely) or
overactive (contracting too quickly or
frequently).
Temporary incontinence
Sometimes incontinence comes and
goes with specific conditions or as a
side effect of a treatment for other
chronic or acute diseases. Temporary
incontinence may be caused by:
O Severe constipation
O Ìnfections in the urinary tract or
vagina
O Certain medications such as
diuretics (water pills); sleeping pills
or muscle relaxants; narcotics, such
as morphine; antihistamines;
antidepressants; antipsychotic
drugs; or calcium channel blockers
Bed-wetting
Ìn addition, some children have
nocturnal enuresis (wetting the bed at
night). Bed-wetting is normal until the
age of 5 years. Ìt is often an inherited
disorder with a delay in neurological
control of the bladder.

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