..How
Does the Urinary System Work?
..What
Causes Problems in the Urinary System?
..How
Are Problems in the Urinary System Detected?
..What
Are Some Disorders of the Urinary System?
..Who
Can Help Me With a Urinary Problem?
..Points
To Remember
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?
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view of urinary tract. |
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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.
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How
Are Problems in the Urinary System 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 of 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 Me With a 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.
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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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