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.
