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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.
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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.
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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.
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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.
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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.
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