Anatomy and Topography of the Urinary Tract System .
The urinary tract system is composed of the kidneys, ureters,
.bladder, and urethra
Kidneys: Bean-shaped organs located on either side of the spine, *
responsible for filtering waste products from the blood and
.producing urine
Ureters: Narrow tubes that carry urine from the kidneys to the *
.bladder
Bladder: A muscular sac that stores urine until it is expelled from *
.the body
Urethra: A tube that carries urine from the bladder to the outside *
.of the body
Evaluation of the Urologic Patient: History and Physical .2
Examination
:History *
Symptoms: frequency, urgency, dysuria, hematuria, pain, *
.incontinence, erectile dysfunction, infertility
.Medical history: diabetes, hypertension, kidney stones, infections *
.Surgical history: previous urological procedures *
.Family history: kidney disease, prostate cancer *
.Social history: smoking, alcohol use, occupation *
:Physical Examination *
.General appearance: vital signs, weight, height *
.Abdominal examination: palpation of kidneys, bladder, masses *
.Genital examination: inspection of penis, scrotum, testicles *
Digital rectal exam (DRE): to assess prostate gland size, *
.tenderness, nodules
Evaluation of the Urologic Patient: Testing and Imaging .3
Urinalysis: To check for blood, protein, bacteria, and other *
.abnormalities
Blood tests: BUN, creatinine, electrolytes, PSA (prostate-specific *
.antigen)
.Urine culture: To identify bacteria causing infection *
:Imaging *
KUB (Kidney, Ureter, Bladder) X-ray: To visualize kidney stones, *
.bladder calculi, and other abnormalities
IVP (Intravenous Pyelography): To assess kidney function, ureters, *
.and bladder
CT scan: To visualize detailed images of the kidneys, ureters, *
.bladder, and surrounding structures
.MRI: To assess soft tissue structures, such as tumors *
Ultrasound: To visualize kidney stones, hydronephrosis, bladder *
.wall thickness, and prostate enlargement
:Kidney, Ureter, and Bladder Urography (KUB) .4
.Indications: Kidney stones, bladder stones, large masses *
.Contraindications: Pregnancy *
:Excretory Urography - Intravenous Pyelography (IVP) .5
.Indications: Kidney stones, obstruction, tumors *
.Contraindications: Allergy to contrast dye, kidney failure *
:Retrograde Ureteropyelography .6
Definition: A procedure where contrast dye is injected into the *
ureters through a cystoscope to visualize the ureters and renal
.pelvis
Technique: A cystoscope is inserted into the urethra and bladder, *
and a catheter is passed through the ureteral orifice to inject
.contrast dye
:Antegrade Ureteropyelography .7
Definition: A procedure where contrast dye is injected directly into *
.the renal pelvis through a percutaneous nephrostomy tube
Technique: A needle is inserted into the kidney under ultrasound *
.or CT guidance, and a catheter is placed to inject contrast dye
:Urethrography .8
.Indications: Urethral stricture, trauma, foreign bodies *
.Contraindications: Allergy to contrast dye, acute urethritis *
:Instrumental Methods of Diagnostics in Urology .9
Cystoscopy: Visual examination of the bladder and urethra using a *
.cystoscope
Urethroscopy: Visual examination of the urethra using a *
.urethroscope
Voiding Cystourethrography (VCUG): X-ray imaging of the bladder *
.and urethra during urination to assess for vesicoureteral reflux
:Cystoscopy .10
Definition: A procedure to visualize the inside of the bladder and *
.urethra using a cystoscope
Indications: Hematuria, bladder cancer, strictures, foreign bodies, *
.stone disease
:Urethroscopy .11
Definition: A procedure to visualize the inside of the urethra using *
.a urethroscope
.Indications: Urethral stricture, trauma, foreign bodies, urethritis *
Urethroscopy: (Same as 11) .12
:Principles of Voiding Cystourethrography (VCUG) .13
Definition: A diagnostic test to assess the function of the bladder *
.and urethra during urination
Principles: A catheter is inserted into the bladder to fill it with *
contrast dye. X-rays are taken as the patient voids to visualize the
.flow of urine and any abnormalities
:VCUG (Voiding Cystourethrography) .14
.Definition: See above *
Indications: Vesicoureteral reflux, voiding dysfunction, recurrent *
.urinary tract infections
Urinary Tract Imaging: Basic Principles of Renal Scintigraphy, CT, .15
MRI, and Plain Film ImagingUrinary Tract Imaging: Basic Principles of
Urologic Ultrasonography
Renal Scintigraphy: Uses radioactive tracers to assess kidney *
.function, blood flow, and damage
CT: Provides detailed cross-sectional images of the kidneys, *
.ureters, bladder, and surrounding structures
MRI: Provides detailed images of soft tissue structures, such as *
.tumors
Ultrasound: Non-invasive imaging technique to visualize kidney *
stones, hydronephrosis, bladder wall thickness, and prostate
.enlargement
Role of Nuclear Medicine in Clinical Urology. Radioisotope .16
:renography (DMSA, DTPA, MAG3)
Nuclear medicine uses radioactive isotopes to assess kidney *
.function, blood flow, and damage
DMSA, DTPA, and MAG3 are radioisotopes used in renal *
.scintigraphy to evaluate various aspects of kidney function
:Hematuria .17
Types: Gross hematuria (visible blood in urine) and microscopic *
.hematuria (blood only detectable by microscopic examination)
:Micro and Macro hematuria .18
Microhematuria: Blood in the urine only detectable by microscopic *
.examination
.Gross hematuria: Visible blood in the urine *
:Evaluation and Management of Hematuria .19
Evaluation: History, physical exam, urinalysis, imaging (KUB, IVP, *
.CT, MRI), cystoscopy
Management: Depends on the underlying cause, which may *
.include kidney stones, bladder cancer, infection, or trauma
:Hydronephrosis .20
.Classification: Mild, moderate, severe *
.Diagnostics: Ultrasound, IVP, CT scan *
:Disorder of urination - Urinary incontinence .21
Causes: Weak pelvic floor muscles, nerve damage, overactive *
.bladder
.Clinical manifestations: Involuntary leakage of urine *
:Disorder of urination - Pollakiuria, nocturia .22
.Pollakiuria: Frequent urination *
.Nocturia: Frequent nighttime urination *
Causes: Overactive bladder, urinary tract infection, prostate *
.enlargement
:Disorder of urination - Ischuria and stranguria .23
.Ischuria: Difficulty initiating urination *
.Stranguria: Painful urination *
Causes: Urinary tract infection, prostate enlargement, urethral *
.stricture
:Quantitative changes in urine: polyuria, oliguria, anuria .24
.Polyuria: Excessive urine output *
.Oliguria: Decreased urine output *
.Anuria: No urine output *
:Anuria .25
.Causes: Kidney failure, obstruction, shock *
.Classification: Prerenal, renal, postrenal *
Qualitative change in urine. Hyper-, hypo- and isostenuria, .26
:hematuriya, proteinuria and pyuria
.Hyperstenuria: Increased urine concentration *
.Hypostenuria: Decreased urine concentration *
.Isostenuria: Fixed urine specific gravity *
.Hematuria: Blood in the urine *
.Proteinuria: Protein in the urine *
.Pyuria: Pus in the urine *
:Urolithiasis. Types of stones .27
.Calcium oxalate: Most common type *
.Uric acid: Associated with gout and low urine pH *
.Struvite: Associated with urinary tract infections *
.Cystine: Rare, hereditary disorder *
:Urolithiasis. Exo- and endogenous factors .28
.Exogenous factors: Diet, fluid intake, medications *
Endogenous factors: Genetic factors, metabolic disorders, urinary *
.tract infections
:Urinary Lithiasis Etiology Epidemiology and Pathogenesis .29
.Etiology: Combination of genetic, dietary, and metabolic factors *
Epidemiology: More common in men, individuals with a family *
.history, and those with certain medical conditions
Pathogenesis: Supersaturation of urine with stone-forming *
.substances, leading to crystal formation and growth
:Complications of Urologic Surgery .30
.Bleeding: Hemorrhage *
.Infection: Urinary tract infection, wound infection *
.Injury to adjacent organs: Bowel, blood vessels *
.Urine leakage: Urinary fistula *
Sexual dysfunction: Erectile dysfunction, retrograde ejac *
[Link] *
Kidney-Day-get-a-deeper-sense-of-your-Nephrotic-Health-Renal-Cell-
[Link]
