1. Urinary System Diseases and Disorders
Chapter 13
Urinary System Diseases and Disorders

2. Anatomy and Physiology
Kidneys
Remove waste products from bloodstream
Ureters
Tubules that run from kidney to bladder
Transport urine

3. Anatomy and Physiology
Bladder
Muscular organ that holds urine
Urethra
Carries urine to outside of body

4. Anatomy and Physiology
Urine normally:
Clear, but slightly yellow to gold
Free from sediments
Distinct odor, but not foul-smelling
Specific gravity of to 1.030
pH of 6
Changes in values indicate disease

5. Animation
Click Here to Play Urine Formation Animation

6. Common Signs and Symptoms
Hematuria
Pyuria
Proteinuria
Dysuria

7. Common Signs and Symptoms
Nocturia
Oliguria
Anuria
Frequency/urgency

8. Diagnostic Tests Urinalysis Urine culture and sensitivity Blood tests
Including blood urea nitrogen (BUN) and creatinine clearance
Intravenous pyelogram (IVP)
Kidney, ureter, and bladder (KUB)

9. Diagnostic Tests Cystogram Cystoscopy Bladder and kidney biopsy
Catheterization

10. Cystoscopy

11. Urinary Tract Infections (UTIs)
Broad diagnosis covering infections of urinary tract
Including urethra, bladder, and kidneys
Most often caused by bacteria
Can be caused by virus and fungi
E. coli
Most common bacteria

12. UTIs More common in females
Female urethra shorter and opening closer to rectum
Some females have improper toilet habits
Vaginal secretions may harbor bacteria while male prostatic secretions have antibacterial effect

13. UTIs More common in females
Sexual intercourse may cause trauma to urethra and bladder leading to inflammation and infection
Pregnant females more susceptible due to pressure of uterus on urinary tract

14. UTIs Diagnosis by urinalysis and culture of urine specimen
Treatment usually antibiotics

15. UTIs Urethritis Inflammation of urethra More common in males
Commonly occurs with cystitis
Symptoms:
Swelling of urethra
Dysuria
Urethral discharge

16. UTIs Cystitis Inflammation of bladder Also known as bladder infection
Honeymoon cystitis
Occurs in females as they become sexually active

17. UTIs Cystitis Treatment usually antibiotics
Antispasmodic medications may decrease bladder spasms
E.g., Pyridium
May cause urine to turn reddish-orange

18. UTIs Pyelitis Inflammation of kidney pelvis
Result of ascending infection from bladder
Rapid diagnosis and treatment imperative to prevent spread of infection

19. UTIs Pyelonephritis May be due to ascending or hematogenous infection
May affect one or both kidneys

20. UTIs Pyelonephritis Symptoms: Treated effectively with antibiotics
Sudden onset of fever and chills
Flank pain
Hematuria
Treated effectively with antibiotics

21. Diseases of the Kidney Acute glomerulonephritis
Inflammation of glomerulus or filtering unit of kidney
Most common kidney disease
Occurs one to four weeks after strep infection

22. Diseases of the Kidney Acute glomerulonephritis Symptoms: Flank pain
Fever
Loss of appetite
Malaise

23. Diseases of the Kidney Acute glomerulonephritis Symptoms:
Edema of eyes and ankles
Oliguria
Hematuria

24. Diseases of the Kidney Acute glomerulonephritis Treatment: Antipyretic
Diuretic
Salt restriction
Protein restriction
Fluid restriction

25. Diseases of the Kidney Chronic glomerulonephritis
Repeated bouts lead to chronic condition
Symptoms include those of acute glomerulonephritis and hypertension
Uremia may occur during late stages
Treatment:
Peritoneal
Hemodialysis

26. Diseases of the Kidney Hydronephrosis
Urine in renal pelvis due to obstruction leading to dilation and distention of kidney pelvis
Diagnosis by pyelogram
Treatment:
Draining of kidney pelvis by surgery
Relief of obstruction

27. Hydronephrosis

28. Diseases of the Kidney Renal calculi Also known as kidney stones
Form in kidney pelvis
Symptoms:
Hematuria
Renal or urinary colic
Extreme spasmodic flank pain

29. Renal Calculi

30. Diseases of the Kidney Renal calculi
Diagnosis by IVP, KUB, and renal ultrasound
Treatment:
Pain medication
Increased fluid intake
Strain urine
Surgery

31. Diseases of the Kidney Polycystic disease
Inherited disease causing enlargement of kidneys due to grape-like cysts
Slow, progressive disease
Symptoms:
Lumbar pain
Hematuria
Recurrent UTIs

32. Diseases of the Kidney Polycystic disease Treatment: No cure
Management of hypertension and UTIs
Dialysis and kidney transplant
No cure

33. Diseases of the Kidney Renal failure
Failure of kidneys to cleanse blood of waste products
BUN and creatinine measure kidney function
May be acute or chronic
Symptoms not significant until 75 percent of kidney function destroyed

34. Diseases of the Kidney Renal failure Treatment:
Management of cause of failure
Limitation of sodium and protein
Measure I & O (intake and output)
Antihypertensives
Diuretics
Antibiotics

35. Diseases of the Kidney Renal failure Long-term treatment: Dialysis
Transplant

36. Arteriovenous (AV) Shunts

37. Diseases of the Kidney Adenocarcinoma of the kidney Risk factor:
Cigarette smoking
Frequently metastasizes to liver, brain, and bone before symptoms appear

38. Diseases of the Kidney Adenocarcinoma of the kidney Symptoms:
Painless hematuria
Flank pain
Fever
Diagnosis by KUB, IVP, CT scan, and biopsy

39. Diseases of the Kidney Adenocarcinoma of the kidney Treatment:
Nephrectomy
Chemotherapy
Radiation

40. Diseases of the Bladder
Urinary incontinence
Loss of urine flow control
Types:
Stress
Urge
Overflow

41. Diseases of the Bladder
Urinary incontinence
Treatment:
Empty bladder
Perform Kegel exercises to strengthen pelvic muscles
Have collagen injections near external sphincter to narrow urethra
Have Marshall-Marchetti-Krantz procedure

42. Diseases of the Bladder
Transitional cell carcinoma of the bladder
Most common neoplasm of urinary tract arising from lining of bladder
Diagnosis by cystoscopy and biopsy
Treatment depends on stage of tumor, transurethral resection (TUR), and cystectomy

43. Trauma
Straddle injuries
Neurogenic bladder

44. Rare Diseases Goodpasture syndrome Interstitial cystitis
Nonbacterial cystitis due to inflammation of inner lining of bladder

45. Effects of Aging Urinary incontinence Prostatic hypertrophy
Older males
Dribbling, frequency, pain or burning, and difficulty starting urine flow