Urinary System Diseases and Disorders

Objectives

• Identify anatomy and physiology of the urinary system

• Recognize common symptoms and treatments of the urinary system diseases and conditions

• Differentiate various diseases/ conditions of the urinary system

Objective #1: Identify anatomy and physiology of the urinary

system

Function of the kidneys

• Excretion of unwanted substances

• Maintenance of water balance

• Regulation of acid-base balance

• Regulation of blood pressure

• Regulation of red blood cell production

Route blood travels through the kidneys

Objective #2: Recognize common symptoms of the

urinary system• Anorexia, nausea, vomiting• Malaise, fatigue, lethargy• Nocturia, hematuria, pyuria, proteinuria• Dysuria, urgency, frequency• Pain in lumbar region, flank, pubic area• Fever• Edema, ascites• Respiratory, cardiovascular (hypertension,

shortness of breath)

Common Drug Treatments for Urinary Tract Diseases

• Diuretics used to treat edema, nephrotic disease, renal failure, cardiovascular disease

• Sulfonamides (TMPSMZ, Septa, Bactrim) used to treat uncomplicated urinary tract infections

• Urinary analgesics (Pyridium)

Objective #3 Differentiate various disease/conditions of

the urinary system

• Polycystic Kidney Disease• Glomerulonephritis• End Stage Renal Disease• Renal Calculi• Cystitis/Urethritis• Tumors of the Bladder

Disease: Cystitis and Urethritis

• Description: inflammation of the bladder/urethra

• Etiology: E-coli?• Signs & Symptoms:

dysuria, frequency, urgency, pain

• Diagnostic procedures: UA

• Treatment: ABO/Sulfa• Prognosis: good

Disease: Tumors of the bladder

• Description: 4th leading cause CA men; malignant; metastasizes

• Etiology: smoking?• Signs & Symptoms:

asymptomatic until advanced; hematuria

• Diagnostic procedures: PE; UA; cystoscopy, IVP

• Treatment: surgery, endoscopic resection, TURP

• Prognosis: varies according to depth

Cystoscopy

• Scope inserted through urethra to view the bladder

• cystoscopy-male

Intravenous Pyelography (IVP)

• X-ray of urinary system including kidneys, ureters, & bladder

• Used to detect tumors, kidney stones, enlarged prostate

Disease: Polycystic Kidney Disease

• Description: defect of collecting tubules (cortex)• Etiology: genetic defect (adult onset)• Signs & Symptoms: colic, lumbar pain, hematuria,

hypertension• Diagnostic procedures: PE reveals enlarged kidneys;

urography; US; CT • Treatment: supportive; dialysis; transplant• Prognosis: poor – no cure

Disease: Glomerulonephritis (Acute poststreptococcal

glomerulonephritis)• Description: inflammation of the

glomeruli; rate of filtration decreased, increase in fluid retention

• Etiology: antigen-antibody complex becomes trapped in capillaries of glomeruli

• Signs & Symptoms: hematuria, H/A, edema, lumbar pain

• Diagnostic procedures: PE (Hx strep?), ↑BUN, ↑ creatinine, rapid SED, UA (blood & protein), renal bx

• Treatment: supportive, bedrest, diet restrictions (salt, protein, fluid)

• Prognosis: good

Disease: End Stage Renal Disease(ESRD); Chronic Renal Failure

(CRF)• Description: gradual

deterioration of kidneys; unable to excrete urea & creatinine (toxic levels)

• Etiology: diabetes; hypertensive renal disease

• Signs & Symptoms: affects all body systems

• Diagnostic procedures: blood tests (↑ creatinine, BUN, K, ↓ hematocrit, hemoglobin; UA reveals protein, low specific gravity; US; renal scan

• Treatment: symptomatic; dialysis; transplant

• Prognosis: very poor

Disease: Renal Calculi (Uroliths, Kidney Stones)

• Description: common cause of urine obstruction

• Etiology: low urine volume, dehydration, UTI, prolonged bedrest

• Signs & Symptoms: sudden, severe flank pain

• Diagnostic procedures: UA, KUB, IVP

• Treatment: lithotripsy; increase fluids; antibiotics

• Prognosis: 60% chance will form another stone