 |
Urinary
Issues
The organs, tubes,
muscles, and nerves that work together to create,
store, and carry urine are the urinary system. The
urinary system includes two kidneys, two ureters,
the bladder, two sphincter muscles, and the urethra.
|
|
 |
|
How
does the Urinary system work?
Your body takes nutrients
from food and uses them to maintain all bodily functions
including energy and self-repair. After your body has taken
what it needs from the food, waste products are left behind
in the blood and in the bowel. The urinary system works
with the lungs, skin, and intestines--all of which also
excrete wastes--to keep the chemicals and water in your
body balanced. Adults eliminate about a quart and a half
of urine each day. The amount depends on many factors, especially
the amounts of fluid and food a person consumes and how
much fluid is lost through sweat and breathing. Certain
types of medications can also affect the amount of urine
eliminated.
The urinary system
removes a type of waste called urea from your blood. Urea
is produced when foods containing protein, such as meat,
poultry, and certain vegetables, are broken down in the
body. Urea is carried in the bloodstream to the kidneys.
The kidneys are bean-shaped
organs about the size of your fists. They are near the middle
of the back, just below the rib cage. The kidneys remove
urea from the blood through tiny filtering units called
nephrons. Each nephron consists of a ball formed
of small blood capillaries, called a glomerulus,
and a small tube called a renal tubule. Urea, together
with water and other waste substances, forms the urine as
it passes through the nephrons and down the renal tubules
of the kidney.
From the kidneys, urine travels
down two thin tubes called ureters to the bladder.
The ureters are about 8 to 10 inches long. Muscles in the
ureter walls constantly tighten and relax to force urine
downward away from the kidneys. If urine is allowed to stand
still, or back up, a kidney infection can develop. Small
amounts of urine are emptied into the bladder from the ureters
about every 10 to 15 seconds.
The bladder is a hollow
muscular organ shaped like a balloon. It sits in your pelvis
and is held in place by ligaments attached to other organs
and the pelvic bones. The bladder stores urine until you
are ready to go to the bathroom to empty it. It swells into
a round shape when it is full and gets smaller when empty.
If the urinary system is healthy, the bladder can hold up
to 16 ounces (2 cups) of urine comfortably for 2 to 5 hours.
Circular muscles called
sphincters help keep urine from leaking. The sphincter
muscles close tightly like a rubber band around the opening
of the bladder into the urethra, the tube that allows
urine to pass outside the body.
Nerves in the bladder
tell you when it is time to urinate (empty your bladder).
As the bladder first fills with urine, you may notice a
feeling that you need to urinate. The sensation to urinate
becomes stronger as the bladder continues to fill and reaches
its limit. At that point, nerves from the bladder send a
message to the brain that the bladder is full, and your
urge to empty your bladder intensifies.
When you urinate, the brain
signals the bladder muscles to tighten, squeezing urine
out of the bladder. At the same time, the brain signals
the sphincter muscles to relax. As these muscles relax,
urine exits the bladder through the urethra. When all the
signals occur in the correct order, normal urination occurs.
|
 |
What
causes Problems in the Urinary system?
Problems in the urinary
system can be caused by aging, illness, or injury. As you
get older, changes in the kidneys' structure cause them to
lose some of their ability to remove wastes from the blood.
Also, the muscles in your ureters, bladder, and urethra tend
to lose some of their strength. You may have more urinary
infections because the bladder muscles do not tighten enough
to empty your bladder completely. A decrease in strength of
muscles of the sphincters and the pelvis can also cause incontinence,
the unwanted leakage of urine. Illness or injury can also
prevent the kidneys from filtering the blood completely or
block the passage of urine. |
How
are the Problems detected?
Urinalysis
is a test that studies the content of urine for abnormal
substances such as protein or signs of infection. This test
involves urinating into a special container and leaving
the sample to be studied.
Urodynamic tests
evaluate the storage of urine in the bladder and the flow
of urine from the bladder through the urethra. Your doctor
may want to do a urodynamic test if you are having symptoms
that suggest problems with the muscles or nerves of your
lower urinary system and pelvis (ureters, bladder, urethra,
and sphincter muscles).
Urodynamic
tests measure the contraction of the bladder muscle as it
fills and empties. The test is done by inserting a small
tube called a catheter through your urethra into
your bladder to fill it either with water or a gas. Another
small tube is inserted into your rectum to measure the pressure
put on your bladder when you strain or cough. Other bladder
tests use x-ray dye instead of water so that x-ray pictures
can be taken when the bladder fills and empties to detect
any abnormalities in the shape and function of the bladder.
These tests take about an hour.
|
What
are some disorders in the Urinary system?
Disorders of the urinary
system range in severity from easy-to-treat to life-threatening.
Benign prostatic hyperplasia
(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. It
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.
Interstitial cystitis
(IC) is a chronic bladder disorder also known as
painful bladder syndrome and frequency-urgency-dysuria syndrome.
In 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 IC 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
(dysuria), and pain in the lower back and genital
area, among other symptoms. In 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.
Renal (kidney)
failure 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 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 renal failure
(CRF) 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
CRF.
Urinary tract infections
(UTIs) are caused by bacteria in the urinary tract.
Women get UTIs more often than men. UTIs are treated with
antibiotics. Drinking lots of fluids also helps by flushing
out the bacteria.
The name of the UTI depends
on its location in the urinary tract. An infection in the
bladder is called cystitis. If the infection is in
one or both of the kidneys, the infection is called pyelonephritis.
This type of UTI 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.
|
Who
can help with my urinary problem?
Your primary doctor can help
you with some urinary problems. Your pediatrician may be able
to treat some of your child's urinary problems. But some problems
may require the attention of a urologist, a doctor
who specializes in treating problems of the urinary system
and the male reproductive system. A gynecologist
is a doctor who specializes in the female reproductive system
and may be able to help with some urinary problems. A urogynecologist
is a gynecologist who specializes in the female urinary system.
A nephrologist specializes in treating diseases of
the kidney. |
Points
to Remember
- Your urinary system filters
waste and extra fluid from your blood.
- Problems in the urinary
system include kidney failure, urinary tract infections,
kidney stones, prostate enlargement, and bladder control
problems.
- Health professionals who
treat urinary problems include general practitioners (your
primary doctor), pediatricians, urologists, gynecologists,
urogynecologists, and nephrologists.
|
|
 |
