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.