Sistem Genitourinaria

Dr. Melya susanti, M.Biomed

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• The urinary system of the human body
consists of
• two kidneys,
• two ureters,
• the bladder and
• a single urethra.
• The kidneys are located on the posterior
wall of the abdomen at waist level.

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• Each kidney is roughly 10 cm long and 5
cm wide, and is encased in a fibrous outer
capsule called the renal capsule.
• The main function of the kidneys is to
control blood volume and composition.
They do this by filtering the blood to
remove waste products, salts and water.
These are secreted in the form of urine.

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• The kidneys are located in the posterior part of the
abdomen.
• There is one on each side of the spine ,the right
kidney sits just below the liver, the left below the
diaphragma and adjacent to the spleen.
• Above each kidney is an adrenal gland (also
called the suprarenal gland). The asymmetry
within the abdominal cavity caused by the liver
results in the right kidney being slightly lower than
the left one while the left kidney is located slightly
more medial.

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• The kidneys are retroperitoneal
• They are approximately at the vertebral
level T12 to L3.
• The upper parts of the kidneys are partially
protected by the eleventh and twelfth ribs.
• Congenital absence of one or both
kidneys, known as unilateral or bilateral
renal agenesis, can occur.

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 Structure of the kidney
• On sectioning, the kidney has a pale outer
region- the cortex- and a darker inner region-
the medulla.
• The medulla is divided into 8-18 conical regions,
called the renal pyramids; the base of each
pyramid starts at the corticomedullary border,
and the apex ends in the renal papilla which
merges to form the renal pelvis and then on to
form the ureter.
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• In humans, the renal pelvis is divided into
two or three spaces -the major calyces-
which in turn divide into further minor
calyces.
• The walls of the calyces, pelvis and
ureters are lined with smooth muscle that
can contract to force urine towards the
bladder by peristalisis.

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• The cortex and the medulla are made up
of nephrons; these are the functional
units of the kidney, and each kidney
contains about 1.3 million of them.

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 Ureter
• The ureters deliver urine to the bladder from the kidney
to bladder.
• The ureters are retroperitoneal, which means that they
are located in the retroperitoneal space .
• In adults the ureters are approx 12 inches (30 cm) long
and have a muscular coat that tightens and relaxes to
move urine away from the kidney. This muscular action
is controlled by the autonomic nervous system (ANS)
and operates in a similar way to that of peristalsis in the
digestive system.

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• The ureters pass through the posterior
surface of the bladder at the Ureter
Orifices.
• Urine drains through the ureters directly
into the bladder as there are no sphincter
muscles or valves at the ureter orifices

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 Bladder
• The bladder is located on the floor of the pelvic
cavity. (Other organs, glands and tissues located
in the pelvic cavity include the rectum, gender-
specific reproductive organs, parts of the small
intestine, blood vessels, lymphatic vessels, and
nerves).
• The bladder is located anterior to (i.e. in front of)
the rectum in males.
• In females it is also in front of the uterus and upper
vagina so its location is described simply as
"anterior to the uterus and upper vagina".

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• The urinary bladder is a
musculomembranous sac whose shape is
affected by factors including the person's
age and sex - as well as the volume of
urine it contains at the time.
• The "superior" or "abdominal" surfaces,
and the "lateral" surfaces of the bladder
are covered by peritoneum.

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Bladder in pelvic cavity.

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 Structure of Bladder

The bladder itself ("musculomembranous sac") consists of 4

layers:
• Serous
The outer "serous" layer is a partial layer derived from the
peritoneum.
• Muscular
The detrusor muscle is the muscle of the urinary bladder
wall.
It consists of three layers of smooth (involuntary) muscle
fibres. The external layer is longitudinal, the middle layer is
circular configuration, and the internal layer is longitudinal .
• Sub-mucous
This is a thin layer of areolar tissue .

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• Mucous
The innermost layer,which contains transitional
epithelium tissue that can stretch.
The ability of this tissue to stretch is important because it contains
variable volumes of liquid - as the bladder is filled and emptied
several times per day. Because it is only loosely attached to the
(strong and substantial) muscular layer, the mucosa falls into
many folds known as rugae when the bladder is empty or is only
filled to a small extent.

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 Female urethra

• At only about 1.5 inches (35 mm) long, the

female adult urethra is shorter than the adult
male urethra (approx. or 8 inches, or 200mm).
• The female urethra is located immediately
behind the pubic symphysis and is embedded
into the front wall of the vagina.

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• The urethra itself is a narrow membranous canal that
consists of three layers:
– Muscular layer - continuous with the muscular layer
of the bladder, this extends the full length of the
urethra.
– Thin layer of spongy erectile tissue - including
plexus of veins and bundles of smooth muscle fibres.
Located immediately below the mucous layer.
– Mucous layer - internally continuous with the bladder
and lined with laminated epithelium that is transitional
near to the bladder.

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• After passing through the urogenital diaphragm ,the
female urethra ends at the external orifice of urethra -
which is the point at which the urine leaves the body.
This is located between the clitoris and the vaginal
opening.
• The passage of urine along the urethra through the
urogenital diaphragm is controlled by the external
urethral sphincter, which is a circular muscle under
voluntary control (that is, it is innervated by the somatic
nervous system, SNS

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 Male urethra

• At about 8-9 inches (200 mm) long, the adult

male urethra is longer than the adult female
urethra (of approx. 1.5 inches 35 mm).
• It has three portions (the prostatic urethra, the
membranous urethra, and the spongy urethra
) and extends from the neck of the bladder to
the meatus urinarius at the end of the male
penis/urethra.

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The three regions/sections of the male
urethra are:
• Prostatic Urethra
The prostatic urethra begins at the neck of
the bladder and includes all of the section
that passes through the prostrate gland.
It is the widest and most dilatable part of the
male urethral canal.

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• Membranous Urethra
– The membranous urethra is the shortest and narrowest part of the
male urethra.
– This section measures approx. 0.5 - 0.75 inches (12 - 19 mm) in length
and is the section of the urethra that passes through the male
urogenital diaphragm.
– The external urethral sphincter (muscle) is located in the urogenital
diaphragm (as for the female urethra).
– The passage of urine along the urethra through the urogenital
diaphragm is controlled by the external urethral sphincter, which is a
circular muscle under voluntary control (that is, it is innervated by the
somatic nervous system, SNS).

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• Spongy Urethra
– The spongy urethra is the longest of the
three sections.
– It is approx. 6 inches (150 mm) in length
– It is contained in the corpus spongiosum that
extends from the end of the membranous
portion, passes through the penis, and
terminates at the external orifice of the
urethra - which is the point at which the urine
leaves the body.
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