Urology and Nephrology Study Guide

Introduction to Urology and Nephrology

  • Urology: The study of urinary structures carrying urine from the kidney to the bladder and out of the body, also concerned with conditions of the male reproductive system.- Urologists treat diseases of males and females and disorders of the male reproductive system.

  • Nephrology: The study of the kidney and how it makes urine.- Nephrologists treat renal failure, kidney and electrolyte imbalances, and kidney disease in dialysis patients.

    • They also provide care for patients who have had kidney transplants.

Functions of the Urinary System

  • The urinary system involves three homeostatic processes:- Excretion

    • Adjusting water and electrolyte levels

    • Filtration

  • The kidneys remove unnecessary substances and water in the form of urine.

  • Urine flows through the ureters to the urinary bladder.

  • The urethra carries urine out from the bladder.

Functions of the Male Reproductive System

  • The male reproductive system produces sperm and secretes testosterone via the testes.

  • Sperm storage and transport and fluid secretion are handled by the other organs:- Epididymis

    • Vas deferens

    • Seminal vesicles

    • Prostate gland

    • Bulbourethral glands

    • Urethra

    • Penis

Urology and Nephrology Combining Forms

  • balan/o: glans penis

  • cyst/o: bladder

  • epididym/o: epididymis

  • glomerul/o: glomerulus

  • lith/o: stone

  • nephr/o: kidney

  • orch/o: testicle

  • orchi/o: testicle

  • orchid/o: testicle

  • prostat/o: prostate gland

  • pyel/o: renal pelvis

  • ren/o: kidney

  • semin/i: semen

  • sperm/o: sperm

  • spermat/o: sperm

  • testicul/o: testicle

  • ur/o: urine

  • ureter/o: ureter

  • urethr/o: urethra

  • urin/o: urine

  • vas/o: vas deferens

  • vesicul/o: seminal vesicle

Other Combining Forms

  • albumin/o: albumin, protein

  • azot/o: nitrogenous waste

  • bacteri/o: bacteria

  • bi/o: life, living

  • corpor/o: body

  • crypt/o: hidden

  • genit/o: genitalia

  • glycos/o: glucose, sugar

  • hem/o: blood

  • hemat/o: blood

  • hydr/o: water

  • noct/i: night

  • olig/o: scanty, few

  • py/o: pus

  • rect/o: rectum

  • varic/o: varicose veins

  • ven/o: vein

  • ADT: Androgen Deprivation Therapy

Suffix Review

  • -al: pertaining to

  • -algia: pain

  • -ar: pertaining to

  • -ary: pertaining to

  • -cele: hernia, swelling

  • -cyte: cell

  • -eal: pertaining to

  • -ectomy: surgical removal

  • -emia: blood condition

  • -genesis: formation, produce

  • -gram: record

  • -graphy: process of recording

  • -ia: condition, state

  • -iasis: abnormal condition

  • -ic: pertaining to

  • -ism: condition, disease

  • -itis: inflammation

  • -lith: stone

  • -logist: specialist in the study of

  • -logy: study of

  • -lysis: breakdown, separation, destruction

  • -megaly: enlargement

  • -meter: instrument to measure

  • -oma: tumor

  • -osis: abnormal condition

  • -ostomy: surgically create an opening

  • -otomy: cutting into; incision

  • -ous: pertaining to

  • -pathy: disease

  • -pexy: surgical fixation

  • -plasia: formation, growth

  • -plasty: surgical repair

  • -ptosis: prolapse, drooping

  • -rrhaphy: suture

  • -rrhea: flow, discharge

  • -sclerosis: hardening

  • -scope: instrument for viewing

  • -scopy: visual examination

  • -stenosis: narrowing

  • -tic: pertaining to

  • -tripsy: crushing

  • -uria: urine condition

Prefix Review

  • a-: without, absence of

  • an-: without, absence of

  • anti-: against

  • dys-: difficult, painful, abnormal

  • epi-: above, upon

  • extra-: outside of

  • hyper-: excessive, above normal

  • hypo-: deficient, below normal

  • intra-: within

  • poly-: many, much

  • trans-: across, through

Organs Treated in Urology and Nephrology

  • Kidneys:-

    • Located on either side of the spine at the lower ribs, outside of the peritoneal membrane.

    • Each kidney is made up of thousands of nephrons.

    • The glomerulus of the nephron filters waste and excess fluid out of the blood to make urine.

    • Urine collects in a holding area of the kidney called the renal pelvis.

    • It then drains into the ureters.

  • Ureters:-

    • Carry urine away from the kidneys and into the urinary bladder.

  • Urinary Bladder:-

    • A muscular, elastic organ that stores urine until it is released.

  • Urethra:-

    • Urine then travels through the urethra and exits the body at the meatus.

Organs Treated in Urology and Nephrology (Male Reproductive System)

  • Testes:-

    • The male reproductive organs that produce sperm and testosterone.-

      • Sperm are male reproductive cells.

      • They contain one-half of the normal chromosomes.

    • The testes are suspended outside of the body in the scrotum.-

      • The scrotum maintains ideal testicular temperature.

      • The scrotum pulls the testes into or lowers them away from the body.

  • Epididymis:-

    • Sperm are stored and matured in the epididymis.

  • Vas Deferens:-

    • Upon ejaculation, sperm enter the vas deferens and travel toward the urethra.

  • Reproductive Glands:-

    • Add fluid to the sperm as it travels through the vas deferens.-

      • The seminal vesicles and bulbourethral glands are paired reproductive glands.

      • The prostate is a single gland.

  • Prostate Gland:-

    • Sperm enter the urethra at the prostate gland.

    • The prostate releases a milky fluid that nourishes sperm and makes up the majority of semen.

  • Penis:-

    • The urethra carries semen through the penis.

    • Semen exits the body at the glans penis.

Building Urology and Nephrology Terms

  • balan/o: glans penis- balanorrhea: discharge from the glans penis

  • cyst/o: bladder- cystalgia: bladder pain

    • cystocele: hernia of the bladder

    • cystolith: stone in the bladder

  • epididym/o: epididymis- epididymal: pertaining to the epididymis

  • lith/o: stone- lithotripsy: crushing of a stone

    • cystolithiasis: condition of stone in bladder

  • nephr/o: kidney- nephromegaly: enlargement of kidney

    • nephroptosis: prolapse of kidney

  • orch/o: testicle- anorchism: state of being without testes

  • orchi/o: testicle- orchiopexy: fixation of a testis

    • orchialgia: testicular pain

  • orchid/o: testicle- orchidectomy: surgical removal of a testis

    • cryptorchidism: state of hidden testis

  • -ostomy: to surgically create an opening- ureterostomy: surgically create an opening in the ureter

    • pyelostomy: surgically create an opening in the renal pelvis

  • prostat/o: prostate gland- prostatectomy: surgical removal of the prostate gland

  • pyel/o: renal pelvis- pyelonephritis: renal pelvis and kidney inflammation

  • ren/o: kidney- renogram: x-ray of the kidney

  • semin/i: semen- seminuria: condition of semen in the urine

  • sperm/o: sperm- aspermatogenesis: condition of being without sperm

    • oligospermia: condition of having scanty sperm

  • spermat/o: sperm- spermatogenesis: produces sperm

    • spermatolysis: to destroy sperm

  • testicul/o: testicle- testicular: pertaining to the testicle

  • ur/o: urine- urology: study of the urine

  • ureter/o: ureter- ureteritis: inflammation of the ureter

    • ureterostenosis: narrowing of the ureter

  • urethr/o: urethra- urethroplasty: surgical repair of the urethra

    • urethralgia: urethral pain

  • -uria: urine condition- glycosuria: sugar urine condition

    • nocturia: night urine condition

  • urin/o: urine- urinometer: instrument to measure urine

  • vas/o: vas deferens- vasectomy: surgical removal of the vas deferens

  • vesicul/o: seminal vesicle- vesiculectomy: surgical removal of the seminal vesicle

Symptoms and Signs

  • Diuresis: Increased formation and secretion of urine.

  • Frequency: Condition of feeling the urge to urinate more often than normal but without an increase in the total daily volume of urine. Can indicate inflammation of the bladder or urethra or benign prostatic hyperplasia.

  • Hesitancy: State of difficulty initiating the flow of urine, often a symptom of blockage along the urethra, such as caused by benign prostatic hyperplasia.

  • Urgency: Feeling the need to urinate immediately.

  • Nocturia: Nighttime urination.

  • Oliguria: Few or scanty urine.

  • Anuria: Condition of kidneys not producing urine.

  • Enuresis: Involuntary discharge of urine after the age by which bladder control should have been established; usually occurs by age five.-

    • Nocturnal enuresis: Bed-wetting at night.

Urinary Incontinence

  • Urinary Incontinence: Involuntary urination; also called enuresis.

  • Stress Incontinence: Loss of urine when pressure is exerted on the bladder by coughing, laughing, exercising, or lifting.

  • Urge Incontinence: A sudden, intense urge to urinate followed by an involuntary loss of urine.

  • Overflow Incontinence: Frequent or constant dribbling of urine. It can occur with a damaged bladder; blocked urethra; nerve damage from diabetes, multiple sclerosis, or spinal cord injury; and in men with prostate problems.

Diseases

  • Calculi: Term for a “stone formed within an organ”; most are formed from mineral salts; commonly found in the kidney, renal pelvis, ureters, bladder, or urethra.

  • (PKD) Polycystic Kidney Disease: Inherited kidney disease characterized by the presence of multiple cysts throughout the kidney tissue; eventually destroys the kidneys and results in kidney failure.

  • Pyelonephritis: An inflammation of the renal parenchyma, calyces, and pelvis; is commonly caused by bacterial infection that has spread up the urinary tract; often associated with structural abnormalities of the urinary tract, kidney stones, prostate disease, or vesicourethral reflex. Most are caused by E. coli.

  • Cystitis: Inflammation of the urinary bladder.

Infective Diseases

  • Gonorrhea: Bacterial sexually transmitted disease; causes inflammation of the urethra of males or cervix of females with purulent discharge.

  • Herpes: Highly infectious viral sexually transmitted disease; causes blister-like lesions on the penis of males or the cervix and vagina of females.

  • Chlamydia: Bacterial sexually transmitted disease; infects the mucous membranes and can spread throughout the entire genitourinary system; often does not cause many symptoms until it is widespread.

  • Syphilis: Bacterial, chronic sexually transmitted disease; begins as a localized ulcer at the point of infection; easily treated early with antibiotics; if left untreated, the infection eventually spreads through lymph nodes to the nervous system, causing death many years later.

  • Trichomoniasis: Protozoan sexually transmitted disease; causes inflammation of the genitourinary tract in both men and women.

  • UTI Urinary Tract Infection: Infection of any region of the urinary tract; characterized by fever, low back or abdominal pain, and burning pain during urination.

  • Chancroid: bacterial STD; highly infectious non-syphilitic venereal ulcer that resembles a syphillic

Other Diseases

  • Glomerulonephritis: Most common form of nephritis, in which the glomeruli within the kidney are inflamed.

  • Nephrotic Syndrome: Abnormal condition of the kidney characterized by marked proteinuria and edema. Can occur as a complication of DM.

  • Renal Failure: Inability of the kidneys to filter wastes from the blood and/or produce urine; treatment of severe renal failure is dialysis or renal transplant.

  • Uremia: Accumulation of nitrogenous waste in the bloodstream; occurs when either or both kidneys fail to filter these wastes from the blood.

  • Urinary Obstruction: Conditions that block or interfere with the flow of urine.

  • Hydronephrosis: Distension of the renal pelvis and kidney by urine that cannot flow past an obstruction in a ureter.

  • Bladder Cancer: more common in men than women.

  • Wilms Tumor: malignant kidney tumor found most often in children; also called nephroblastoma.

Diseases of Men

  • (ED) Erectile Dysfunction: Inability to achieve erection of the penis for coitus; also called impotence.

  • Hydrocele: Accumulation of fluid within the scrotum.

  • Hypospadias: Congenital malformation of the penis with the urethra opening on the underside of the penis.

  • Epispadias: Congenital malformation of the penis with the urethra opening located above the usual opening.

  • Phimosis: Narrowing of the prepuce over the glans penis; may cause difficulty with urination and infection; treatment is circumcision.

  • Priapism: Persistent and painful erection due to pathological causes, not sexual arousal.

  • Sterility: Inability to produce children; in males, it is usually due to a problem with sperm production, such as aspermia or oligospermia; also called infertility.

  • Testicular Carcinoma: Cancer of one or both testicles; more commonly seen in young men or boys.

  • Cryptorchidism: Congenital anomaly involving failure of one or both of testes to descend into the scrotal sac before birth; a surgical procedure called orchiopexy may be required to bring the testes down into the scrotum permanently; also called cryptorchidism.

  • Testicular Torsion: twisting of the spermatic cord.

  • Varicocele: Development of varicose veins in the scrotal veins.

  • (BPH) Benign Prostatic Hyperplasia: Nonmalignant, noninflammatory enlargement of the prostate; condition places pressure on the urethra and narrows it, resulting in frequency, urgency, and nocturia; commonly seen in males over age 50.

  • Prostate Cancer: Common and slow-growing cancer of the prostate gland occurring in males over age 50; prostate-specific antigen (PSA) test is used to assist in early detection of this disease.

  • Anorchism: absence of testes; may be congenital or as a result of accident or surgery

Diagnosis

  • Urinalysis (UA): Laboratory test that consists of physical, chemical, and microscopic examination of the urine.-

    • pH

    • Specific gravity

    • Proteins: Presence indicates glomerulonephritis or preeclampsia in pregnant women.

    • Glucose: Presence indicates uncontrollable diabetes.

    • Ketones: Presence indicates diabetic ketoacidosis, dehydration, starvation.

    • WBC: Presence indicates infection.

    • Blood: Presence indicates glomerulonephritis, cancer of the urinary tract, trauma.

    • Casts: Gelatinous structures that take the shape of the renal tubules. Presence of many casts can be due to renal diseases or stones.

  • Clean Catch: Procedure for obtaining a urine sample after cleaning off the urethral meatus and catching urine in midstream (halfway through the urination process) to minimize contamination from the skin.

  • Culture & Sensitivity (C&S): Diagnostic lab procedure that identifies bacterial infection of the urinary system and determines the best antibiotic to treat it; involves growing bacteria in culture medium and testing different antibiotics on it.

  • (BUN) Blood Urea Nitrogen: Blood test to determine kidney function by measuring the level of nitrogenous waste, or urea, in the blood.

  • Creatinine Clearance: test to evaluate kidney function; creatinine is a waste product cleared from the blood stream by kidneys. For this test urine is collected for 24 hours, and the amount of creatinine in urine compared to creatinine remains in the blood

  • (IVP) Intravenous Pyelogram: X-ray of the kidney following injection of dye into a vein to visualize renal pelvis as the kidney filters dye out of the bloodstream and puts it into the urine.

  • Excretory Urography: X-ray images of the entire urinary system or part of it after the urine has been rendered opaque by an IV injected contrast medium. Both structural and functional abnormalities can be detected.

  • (RP) Retrograde Pyelogram: X-ray of the urinary bladder, ureters, and renal pelvis following insertion of dye through the urethra.

  • (KUB) Kidneys, Ureters, Bladder: an X-ray o kidney, ureters and bladder

  • (cath) Catheterization: Insertion of a flexible tube, or catheter, into the urinary bladder through the urethra; used to withdraw urine or insert dye.

  • (VCUG) Voiding Cystourethrogram: X-rays made while the patient voids dye that has been placed in the urinary bladder through the urethra

Diagnosis of Male Reproductive System

  • (PSA) Prostate-Specific Antigen: Blood test to screen for prostate cancer. Elevated PSA indicates prostate cancer.

  • Semen Analysis: Evaluation of the semen for fertility; sperm in the semen are analyzed for number, swimming strength, and shape; procedure is also used to determine if a vasectomy has been successful.

  • Digital Rectal Exam: manual examination for enlarged prostate gland performed by palpating (feeling) the prostate gland though the wall of the rectum.

Other Diagnostic Tests

  • (I & O) Intake and Output: A 24-hour test to check the oral/IV/tube feeding and the urine output.

  • Pyuria: Pus cells (necrotic WBCs) are in the urine.

  • Creatinine Clearance Rate (CCr): Diagnostic test that measures the rate at which creatinine is cleared from the blood by the kidney.

  • Cystometry: Provides information about the amount of pressure exerted on the bladder wall.

  • Cystometrogram Measures bladder capacity in relation to changing urine pressure

  • Cystography: Radiography of the bladder using radiopaque contrast medium.

  • Cystourethrography: Radiography of the bladder and urethra after using a urinary catheter to instill the contrast medium.

  • (VCUG) Voiding Cystourethrogram: Radiograph made before, during, and after voiding. This procedure checks for reflux (abnormal backflow) of urine.

  • Cystoscopy: a pencil thin flexible tube-like optical instrument is inserted through the urethra into the bladder to examine the bladder’s lining and to take a biopsy if needed.

Treatment – Medical

  • Antibiotics: Medication used to treat bacterial infections.

  • Antispasmodics: Prevents or reduces bladder muscle spasms.

  • Diuretics: Increases the volume of urine produced by the kidneys; useful in the treatment of edema, kidney failure, heart failure, and hypertension.

Treatment

  • (ESWL) Extracorporeal Shock Wave Lithotripsy: Treatment procedure for urinary system stones; utilizes ultrasound waves to break up stones; the process is noninvasive, meaning it does not require surgery.

Treatment – Catheterization

  • Foley Catheter: Type of indwelling catheter designed to be left in place for a prolonged period.

  • Ureteral Catheterization Insertion of the catheter into the distal part of the ureter through the urethra, bladder and into the ureter with cystoscopy guidance or inserted through the abdominal wall.

  • Suprapubic Catheterization: Surgical insertion of a catheter through the skin above the pubic bone into the bladder.

Treatment – Dialysis

  • Peritoneal Dialysis: Artificial means to remove wastes by placing a warm, chemically balanced solution into the peritoneal cavity; treatment for renal failure.

  • (HD) Hemodialysis: Treatment for renal failure using an artificial kidney machine to filter waste from the blood.

Treatment – Male Diseases

  • (ADT) Androgen Deprivation Therapy: Using medicine to reduce the amount of testosterone produced by the testes; treatment for prostate cancer.

  • HPV Vaccine: Human papillomavirus vaccine: protect against HPV infection

  • Orchiectomy: surgically remove the testes

  • Orchidectomy: surgical removal of on or both testes

  • Prostatectomy: surgical removal of the prostate

Surgical Treatment

  • Pyelostomy Surgical insertion of a catheter via a new opening into the renal pelvis through the overlying skin

  • Renal Transplant: Replacement of diseased kidney by a donor kidney

  • (TURP) Transurethral Resection of the Prostate: Surgical removal of prostate tissue by inserting a device called a resectoscope through the urethra and removing prostate tissue; may also be referred to as transurethral resection (TUR).

  • Circumcision: Surgical removal of the prepuce, or foreskin, from the glans penis; commonly performed on newborn males at the request of parents; the primary reason is for ease of hygiene; also a ritual practiced in some religions.

Urology and Nephrology Abbreviations

  • ARF: acute renal failure

  • BPH: benign prostatic hyperplasia

  • BUN: blood urea nitrogen

  • C&S: culture and sensitivity

  • cath: catheterization

  • CRF: chronic renal failure

  • cysto: cystoscopy

  • DRE: digital rectal exam

  • ED: erectile dysfunction

  • ESRD: end-stage renal disease

  • ESWL: extracorporeal shock wave lithotripsy

  • GU: genitourinary

  • HD: hemodialysis

  • HPV: human papillomavirus

  • I & O: intake and output

  • IVP: intravenous pyelogram

  • KUB: kidneys, ureters, bladder

  • PKD: polycystic kidney disease

  • PSA: prostate-specific antigen

  • RP: retrograde pyelogram

  • STI STD: sexually transmitted infection/disease

  • TUR: transurethral resection

  • TURP: transurethral resection of the prostate

  • UA: urinalysis

  • UTI: urinary tract infection

  • VCUG: voiding cystourethrogram

  • VD: venereal disease