Urology & Urinary System

Urology

The study of the anatomy and physiology of the urinary system

Urinary System

Starts in the kidneys and ends in excretion through the urethra. Removes waste products of cellular metabolism from the blood by producing, transporting, and storing and excreting

Anatomy: Ureter connects kidney to bladder; bladder connects to urethra. Kidneys filter the blood to remove said waste from capillaries (nephrons)

Nephrons remove waste and then filter through cells to form urine

Nephropathy

Any disease of the kidney.

Nephroptosis

Abnormally low position of a kidney. Can be caused by extreme weight loss. May cause the ureter to collapse on itself causing distortion & issues in urination

-ptosis=state of drooping

Renal Failure

Disease in which urine production decreases and may stop. Can be chronic or acute

Acute Kidney Injury: sudden onset usually due to trauma, blood loss, or a severe infection

Chronic Kidney Disease: gradual onset with renal insufficiency progressing to renal failure

Polycystic Kidney Disease

Hereditary disease characterized by cysts in the Kidney. These growths can eventually destroy nephrons and cause kidney failure

Pyelonephritis

Infection & inflammation of the renal pelvis. Can be caused by bacteria traveling through the bladder & ureters into the bladder

Renal Cell Cancer

A cancerous tumor (carcinoma) that begins in the epithelial cells in the tubules of the nephron

Hydronephrosis

Condition where the urine distends the renal pelvis & calices or ureter. Occurs for numerous reasons (blood clot, infection, kidney stones, etc)

Glomerulonephritis

Inflammation and inflection of the glomeruli; occurs as a complication of acute viral or streptococcal infection. Antibodies clog the pores of the capillaries in the glomeruli

Uremia

Excessive buildup of urea in the blood due to renal failure

UTI

Bacterial infection somewhere in the urinary tract. Usually caused by E. Coli that have traveled from rectum to urethra

Nephrolithiasis

Formation of kidney stones in the urinary system; scraping of the stone against the ureter and bladder mucosa causes muscle spasms. Severe pain, nausea, vomiting, and/or hematuria

Bladder Cancer

Presence of Carcinoma in the epithelial cells of the Bladder

Cystitis

Infection/Inflammation of the bladder often due to bacterial infection

Cystocele

Hernia in which the bladder bulges through a weakness in the vaginal wall or rectum. Causes retention of urine inside the hernia

Neurogenic Bladder

Nerves of the bladder are not working properly. Causes urinary retention because the bladder does not contract

Overactive Bladder

Too many involuntary contractions resulting in urgency & frequency; known as urge incontinence

Urinary Retention

Inability to empty the bladder. Caused by many causes. When the bladder contracts, a large amount of urine (postvoid residual) remains

Vesicovaginal Fistula

Abnormal passageway connecting the bladder to the vagina; urine flows through the passageway and leaks through the vagina. Occurs commonly when a young woman’s body is too small and underdeveloped to give birth safely

Incontinence

Inability to voluntarily keep urine in the bladder. Can be caused by injury, surgery, or others

Stress Urinary Incontinence: Caused by weakened pelvic floor muscles

Urethritis

Infection/Inflammation of the urethra

Anuria

Complete absence of urine production by the kidneys

Oliguria

Decreased production of urine due to kidney failure or dehydration

Olig/o=few or scanty

Dysuria

Difficult or painful urination

Polyuria

Excessive urine production; common symptom of diabetes, Part of the three P’s

Frequency, Urgency, & Hesitancy

The first means Urinating often, usually in small amounts

The second means Feeling the need to pee with very little being expressed

Another term for the third is Bladder shyness

Nocturia

Increased frequency of urination at night

Bacteriuria

The presence of Bacteria in the urine; indicates an infection

Pyuria

Presence of white blood cells or pus in the urine

Albuminuria

Presence of albumin in the urine; called proteinuria. Can indicate kidney disease or preeclampsia

Glycosuria

Presence of glucose in the urine; associated with uncontrolled diabetes mellitus

Ketonuria

Presence of ketones in the urine; occurs when the body metabolizes fat rather than glucose. Another sign of diabetes mellitus

Hematuria

Blood in the urine; may have gross (visible) blood or microscopic

Terms related to the Bladder

Cysto- is used for diseases of the bladder

Adjective form of bladder is vesical. However, Vesicle is different (small space for compounds such as neurotransmitters)

Urethra Anatomy

Internal urethral Sphincter: Involuntary control

External Urethral sphincter: Voluntary control. This is the mechanism behind being able to “hold it” until excretion is convenient

Urinalysis

Abbreviated UA. Looks at the general characteristics of a patient's urine and detects substances in it.

Drug testing is often done this way

Albumin

If this protein is found in the urine, it indicates damage to the glomerulus of the Kidneys

Urine Color

Normal=light yellow to amber

Pink/reddish=bleeding in the urinary system

Turbid (opaque/not clear) =Presence of UTI

Glucose

If found in urine, can indicate uncontrolled diabetes

Ketones

If found in the urine, can indicate that the body is using fat instead of glucose for energy. Another sign of diabetes

Odor

Normally has a faint odor, but if it smells sweet, that can indicate diabetes or insulin resistance

pH

Normal is slightly alkaline, somewhere around 7

Red Blood Cells

Presence in the urine indicates bleeding somewhere in the urinary tract

Sediment

Crystals such as uric acid or calcium oxalate can indicate and form kidney stones

Epithelial cells are generally normal since they are constantly being shed

Specific Gravity

Measures the concentration of urine compared to water

White Blood Cells

Indicates urinary tract infection. If the specimen is cloudy or milky, it can be labeled as to numerous to count (TNTC)

Blood Urea Nitrogen

Measures the amount of urea found in the blood. Elevated levels suggests that kidneys are not functioning

Creatinine

Measures the amount of creatinine in the blood. Elevated levels can indicate that the kidneys are not working properly. Creatinine=byproduct of muscle metabolism

Leukocyte Esterase

Urine dipstick test to detect esterase, which is associated with the white blood cells present in a UTI

Culture & Sensitivity (C&S)

Urine sample is swabbed for bacteria can be cultured & determines what antibiotic(s) they are sensitive to

Intake & Output (I&P)

Documenting total amount of fluid intake and total amount of fluid output over a day.

Catheterization

Insertion of a catheter through the urethra and into the bladder to drain urine without the patient facilitating excretion. Bag is attached to measure output

Condom: Fits over the penis and collects urine as it leaves the Urethra

Foley: Kept in place with a balloon inside the bladder

Dialysis

Procedure to remove waste products from the blood of a patient in renal failure

Hemodialysis: Cleaning the blood through a machine running blood through it

Peritoneal dialysis: Permanent catheter is inserted through the abdominal wall. Dialysate fluid is pumped in for several hours, then removed along with blood waste products

dia=complete, -lysis=breakdown

Antibiotics

Mainly used to treat UTIs

Antispasmodics

Relax smooth muscles in the wall of the urinary bladder. Treats cystitis or overactive bladder

Diuretics

Blocks Sodium reabsorption in the kidney, which decreases blood volume and increase urine volume

Drugs for treatment of Overactive Bladder

Decreases smooth muscle contractions in the bladder

Potassium Supplements

Replaces the potassium lost when taking diuretic drugs

Urinary Analgesics

Relieve pain in the mucosa of the urinary tract.

Intravenous Pyelography (IVP)

Procedure to inject contrast dye to visualize the urinary system. Looks for the structures to see if there are obstructions

Kidneys, Ureters, Bladder (KUB) X-Ray

Shows only the structures of the Kidneys, Ureters, and Bladder. Looks for stones

Renal Angiography

Uses x-rays and radiopaque dye to produce images of the renal artery

Ultrasonography

Uses Ultrasound to produce images of the Urinary System. Primarily used to look for blockages and/or stones

Voiding Cystourethrography (VCUG)

X-ray used to watch contrast dye excretion as the patient pees

Lithotripsy

Using laser sound waves to break up a kidney stone.

Nephrolithotomy

Endoscope is inserted into the kidney through a slit in the skin and then used to remove a stone lodged in the renal pelvis of calices

Stone Basketing

Cystoscope is inserted into the bladder, then a small wire basket is passed through the scope to grab & remove kidney stones from the bladder or ureter

Cystectomy

Removal of the bladder, most often due to bladder cancer

Cystoscopy

Use of a Cystoscope to examine the inside of the bladder. Inserted through the urethra

Bladder Neck Suspension

Corrects stress urinary incontinence by implanting a supportive sling of muscle tissue or mesh to support the bladder & urethra

Renal Biopsy

A procedure to remove a small part of the Kidney to analyze under a microscope

Nephrectomy

Surgical removal of diseased or cancerous kidney, but also used to remove a healthy kidney from a donor

Nephropexy

Correction of an abnormally low kidney by suturing it into the correct position

Kidney Transplant

Procedure to treat a person in end stage renal failure by implanting a donor kidney. Donor & Recipient must be blood & tissue matches along with taking immunosuppressants to reduce rejection & death.

Urethroplasty

Plastic surgery to reposition the urethral opening in male patients who have epispadias or hypospadias