Urologic diseases or conditions include
urinary tract infections,
kidney stones,
bladder control problems, and
prostate problems, among others. Some urologic conditions do not affect a person for that long and some are lifetime conditions.[1] Kidney diseases are normally investigated and treated by
nephrologists, while the specialty of
urology deals with problems in the other organs.
Gynecologists may deal with problems of
incontinence in women.
Diseases of other bodily systems also have a direct effect on urogenital function. For instance, it has been shown that
protein released by the kidneys in
diabetes mellitus sensitizes the kidney to the damaging effects of
hypertension.[2]Diabetes also can have a direct effect on
urination due to
peripheral neuropathies, which occur in some individuals with poorly controlled diabetics.
Kidney disease, or renal disease, also known as nephropathy, is damage to or
disease of a
kidney.
Nephritis is an
inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can be diagnosed by
blood tests.
Nephrosis is non-inflammatory kidney disease. Nephritis and nephrosis can give rise to
nephritic syndrome and
nephrotic syndrome respectively. Kidney disease usually causes a loss of
kidney function to some degree and can result in
kidney failure, the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where
dialysis or a
kidney transplant is the only treatment option.
Chronic kidney disease causes the gradual loss of kidney function over time. Acute kidney disease is now termed
acute kidney injury and is marked by the sudden reduction in kidney function over seven days. About one in eight Americans (as of 2007) has chronic kidney disease.[3] Primary renal cell carcinomas as well as metastatic cancers can affect the
kidney.
Structural and or traumatic changes in the urinary tract can lead to
hemorrhage, functional blockage or
inflammation.
Colonization by
bacteria,
protozoa or
fungi can cause infection. Uncontrolled cell growth can cause
neoplasia. The term "uropathy" refers to a disease of the urinary tract, while "
nephropathy" refers to a disease of the kidney. For example:
Urinary tract infections (UTIs) are
infections that affect part of the
urinary tract.[8] When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidney infection (
pyelonephritis).[9] Symptoms from a lower urinary tract infection include pain with
urination, frequent urination, and feeling the need to urinate despite having an empty bladder.[8] Symptoms of a kidney infection include
fever and
flank pain usually in addition to the symptoms of a lower UTI.[9] Rarely the urine may appear
bloody.[10] In the very old and the very young, symptoms may be vague or non-specific.[8][11]
Incontinence (UI), also known as involuntary urination, is any uncontrolled
leakage of urine. It is a common and distressing problem, which may have a large impact on
quality of life.[14] It has been identified as an important issue in geriatric health care.[15] The term
enuresis is often used to refer to urinary incontinence primarily in children, such as
nocturnal enuresis (bed wetting).[16]
Renal cell carcinoma (RCC) is a
kidney cancer that originates in the lining of the
proximal convoluted tubule, a part of the very small tubes in the kidney that transport primary urine. RCC is the most common type of kidney cancer in adults, responsible for approximately 90–95% of cases.[26]
Urinary tract obstruction is a urologic disease consisting of a decrease in the free passage of
urine through one or both
ureters and/or the
urethra. It is a cause of
urinary retention. Complete obstruction of the urinary tract requires prompt treatment for renal preservation.[32] Any sign of infection, such as fever and chills, in the context of obstruction to urine flow constitutes a urologic emergency.[32]
Testing
Biochemical blood tests determine the amount of typical markers of renal function in the blood serum, for instance serum
urea, serum
uric acid, and serum
creatinine.[33] Biochemistry can also be used to determine serum electrolytes.[33] Special biochemical tests (
arterial blood gas) can determine the amount of dissolved gases in the blood, indicating if pH imbalances are acute or chronic.[34]
Urinalysis is a test that studies
urine for abnormal substances such as protein or signs of infection.[35] A
Full Ward Test, also known as dipstick urinalysis, involves the dipping of a biochemically active test strip into the urine specimen to determine levels of tell-tale chemicals in the urine.[36] Urinalysis may also involve MC&S
microscopy,
culture and
sensitivity
Urodynamic tests evaluate the storage of urine in the bladder and the flow of urine from the bladder through the urethra.[37] It may be performed in cases of incontinence or neurological problems affecting the urinary tract. However the American Urogynecologic Society does not recommend that urodynamics are part of initial diagnosis for uncomplicated overactive bladder.[38]
Ultrasound is routinely used in
urology. In a pelvic sonogram, organs of the pelvic region are imaged. This includes the
uterus and
ovaries or
urinary bladder. Males are sometimes given a pelvic sonogram to check on the health of their bladder, the
prostate, or their
testicles (for example to distinguish
epididymitis from
testicular torsion). In young males, it is used to distinguish more benign masses (
varicocele or
hydrocele) from
testicular cancer, which is highly curable but which must be treated to preserve health and fertility. There are two methods of performing a pelvic sonography – externally or internally. The internal pelvic sonogram is performed either trans
vaginally (in a woman) or transrectally (in a man). Sonographic imaging of the pelvic floor can produce important diagnostic information regarding the precise relationship of abnormal structures with other pelvic organs and it represents a useful hint to treat patients with symptoms related to pelvic prolapse, double incontinence and obstructed defecation. It is used to diagnose and, at higher frequencies, to treat (break up) kidney stones or kidney crystals (
nephrolithiasis).[39]
KUB stands for
Kidneys,
Ureters, and
Bladder. The projection does not necessarily include the diaphragm. The projection includes the entire urinary system, from the
pubic symphysis to the superior aspects of the kidneys. The
anteroposterior (AP) abdomen projection, in contrast, includes both halves of the diaphragm.[40][41] Despite its name, a KUB is not typically used to investigate pathology of the kidneys, ureters, or bladder, since these structures are difficult to assess (for example, the kidneys may not be visible due to overlying bowel gas.) In order to assess these structures radiographically, a technique called an
intravenous pyelogram was historically utilized, and today at many institutions CT urography is the technique of choice.[42]
CT urography (CTU) is commonly used in the evaluation of hematuria, and specifically tailored to image the renal collecting system, ureters and bladder in addition to the
renal parenchyma. Initial imaging includes a noncontrast phase to detect renal calculi as a source of hematuria. Note that dual energy CT may eventually allow the noncontrast phase to be eliminated. Contrast enhancement techniques for CTU vary from institution to institution. A common technique is a double bolus, single phase imaging algorithm. This technique is a hybrid contrast injection strategy that results in opacification of the renal parenchyma and the collecting system, ureters, and bladder. A small contrast bolus is administered initially, followed 10 minutes later with a larger bolus that is imaged in the corticomedullary phase. Excretory phase imaging allows for not only evaluation of the ureteral lumen, but also periureteral abnormalities including external masses and lymphadenopathy.[citation needed]
A
voiding cystogram is a functional study where contrast "dye" is injected through a catheter into the bladder. Under x-ray the radiologist asks the patient to void (usually young children) and will watch the contrast exiting the body on the x-ray monitor. This examines the child's bladder and lower urinary tract. Typically looking for
vesicoureteral reflux, involving urine backflow up into the kidneys.[45]
References
^
abc"Kidney Failure". National Institute of Diabetes and Digestive and Kidney Diseases. 2017-10-01. Retrieved 2019-06-17.
^
abLane, DR; Takhar, SS (August 2011). "Diagnosis and management of urinary tract infection and pyelonephritis". Emergency Medicine Clinics of North America. 29 (3): 539–52.
doi:
10.1016/j.emc.2011.04.001.
PMID21782073.
^Salvatore S, Salvatore S, Cattoni E, Siesto G, Serati M, Sorice P, Torella M (June 2011). "Urinary tract infections in women". European Journal of Obstetrics, Gynecology, and Reproductive Biology. 156 (2): 131–6.
doi:
10.1016/j.ejogrb.2011.01.028.
PMID21349630.
^Ackley, Betty (2010). Nursing diagnosis handbook : an evidence-based guide to planning care (9th ed.). Maryland Heights, Mo: Mosby.
ISBN9780323071505.
^Venes, Donald (2013). Taber's cyclopedic medical dictionary. Philadelphia: F.A. Davis.
ISBN9780803629776.
^Collins MM, Stafford RS, O'Leary MP, Barry MJ (1998). "How common is prostatitis? A national survey of physician visits". J. Urol. 159 (4): 1224–8.
doi:
10.1016/S0022-5347(01)63564-X.
PMID9507840.
^
abcdefghij"Urinary Retention". National Institute of Diabetes and Digestive and Kidney Diseases. Aug 2014.
Archived from the original on 4 October 2017. Retrieved 24 October 2017.
^Sliwinski, A; D'Arcy, FT; Sultana, R; Lawrentschuk, N (April 2016). "Acute urinary retention and the difficult catheterization: current emergency management". European Journal of Emergency Medicine. 23 (2): 80–8.
doi:
10.1097/MEJ.0000000000000334.
PMID26479738.
S2CID26988888.
^"Cancer Fact sheet N°297". World Health Organization. February 2014.
Archived from the original on 29 December 2010. Retrieved 10 June 2014.
^"Defining Cancer". National Cancer Institute. 17 September 2007.
Archived from the original on 25 June 2014. Retrieved 10 June 2014.
^Curti, B; Jana, BRP; Javeed, M; Makhoul, I; Sachdeva, K; Hu, W; Perry, M; Talavera, F (26 February 2014). Harris, JE (ed.).
"Renal Cell Carcinoma". Medscape Reference. WebMD.
Archived from the original on 7 March 2014. Retrieved 7 March 2014.
^"Prostate Cancer". National Cancer Institute. January 1980.
Archived from the original on 12 October 2014. Retrieved 12 October 2014.
^
abChowdhury SH, Cozma AI, Chowdhury JH. Urinary Tract Obstruction. Essentials for the Canadian Medical Licensing Exam: Review and Prep for MCCQE Part I. 2nd edition. Wolters Kluwer. Hong Kong. 2017.
^Po, Henry N.; Senozan, N. M. (2001). "The Henderson-Hasselbalch Equation: Its History and Limitations". Journal of Chemical Education. 78 (11). American Chemical Society (ACS): 1499.
Bibcode:
2001JChEd..78.1499P.
doi:
10.1021/ed078p1499.
ISSN0021-9584.
^Yetisen, Ali Kemal; Akram, Muhammad Safwan; Lowe, Christopher R. (2013-05-21). "Paper-based microfluidic point-of-care diagnostic devices". Lab on a Chip. 13 (12): 2210–2251.
doi:
10.1039/C3LC50169H.
ISSN1473-0189.
PMID23652632.
^Frank, Eugene D.; Long, Bruce W.; Smith, Barbara J. (2012). Merrill's Atlas of Radiographic Positioning & Procedures (12 ed.). St. Louis, MO: Mosby Inc.
ISBN978-0-323-07334-9.
^Bontrager, Kenneth L.; Lampignano, John P. (2005). Textbook of Radiographic Positioning and Related Anatomy (6 ed.). St. Louis, MO: Mosby, Inc.
ISBN978-0-323-02507-2.
^Frimberger, Dominic; Bauer, Stuart B.; Cain, Mark P.; Greenfield, Saul P.; Kirsch, Andrew J.; Ramji, Faridali; Mercado-Deane, Maria-Gisela; Cooper, Christoper S. (2016-12-01). "Establishing a standard protocol for the voiding cystourethrography". Journal of Pediatric Urology. 12 (6): 362–366.
doi:
10.1016/j.jpurol.2016.11.001.
ISSN1477-5131.
PMID27939178.
S2CID21041368.
Urologic diseases or conditions include
urinary tract infections,
kidney stones,
bladder control problems, and
prostate problems, among others. Some urologic conditions do not affect a person for that long and some are lifetime conditions.[1] Kidney diseases are normally investigated and treated by
nephrologists, while the specialty of
urology deals with problems in the other organs.
Gynecologists may deal with problems of
incontinence in women.
Diseases of other bodily systems also have a direct effect on urogenital function. For instance, it has been shown that
protein released by the kidneys in
diabetes mellitus sensitizes the kidney to the damaging effects of
hypertension.[2]Diabetes also can have a direct effect on
urination due to
peripheral neuropathies, which occur in some individuals with poorly controlled diabetics.
Kidney disease, or renal disease, also known as nephropathy, is damage to or
disease of a
kidney.
Nephritis is an
inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can be diagnosed by
blood tests.
Nephrosis is non-inflammatory kidney disease. Nephritis and nephrosis can give rise to
nephritic syndrome and
nephrotic syndrome respectively. Kidney disease usually causes a loss of
kidney function to some degree and can result in
kidney failure, the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where
dialysis or a
kidney transplant is the only treatment option.
Chronic kidney disease causes the gradual loss of kidney function over time. Acute kidney disease is now termed
acute kidney injury and is marked by the sudden reduction in kidney function over seven days. About one in eight Americans (as of 2007) has chronic kidney disease.[3] Primary renal cell carcinomas as well as metastatic cancers can affect the
kidney.
Structural and or traumatic changes in the urinary tract can lead to
hemorrhage, functional blockage or
inflammation.
Colonization by
bacteria,
protozoa or
fungi can cause infection. Uncontrolled cell growth can cause
neoplasia. The term "uropathy" refers to a disease of the urinary tract, while "
nephropathy" refers to a disease of the kidney. For example:
Urinary tract infections (UTIs) are
infections that affect part of the
urinary tract.[8] When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidney infection (
pyelonephritis).[9] Symptoms from a lower urinary tract infection include pain with
urination, frequent urination, and feeling the need to urinate despite having an empty bladder.[8] Symptoms of a kidney infection include
fever and
flank pain usually in addition to the symptoms of a lower UTI.[9] Rarely the urine may appear
bloody.[10] In the very old and the very young, symptoms may be vague or non-specific.[8][11]
Incontinence (UI), also known as involuntary urination, is any uncontrolled
leakage of urine. It is a common and distressing problem, which may have a large impact on
quality of life.[14] It has been identified as an important issue in geriatric health care.[15] The term
enuresis is often used to refer to urinary incontinence primarily in children, such as
nocturnal enuresis (bed wetting).[16]
Renal cell carcinoma (RCC) is a
kidney cancer that originates in the lining of the
proximal convoluted tubule, a part of the very small tubes in the kidney that transport primary urine. RCC is the most common type of kidney cancer in adults, responsible for approximately 90–95% of cases.[26]
Urinary tract obstruction is a urologic disease consisting of a decrease in the free passage of
urine through one or both
ureters and/or the
urethra. It is a cause of
urinary retention. Complete obstruction of the urinary tract requires prompt treatment for renal preservation.[32] Any sign of infection, such as fever and chills, in the context of obstruction to urine flow constitutes a urologic emergency.[32]
Testing
Biochemical blood tests determine the amount of typical markers of renal function in the blood serum, for instance serum
urea, serum
uric acid, and serum
creatinine.[33] Biochemistry can also be used to determine serum electrolytes.[33] Special biochemical tests (
arterial blood gas) can determine the amount of dissolved gases in the blood, indicating if pH imbalances are acute or chronic.[34]
Urinalysis is a test that studies
urine for abnormal substances such as protein or signs of infection.[35] A
Full Ward Test, also known as dipstick urinalysis, involves the dipping of a biochemically active test strip into the urine specimen to determine levels of tell-tale chemicals in the urine.[36] Urinalysis may also involve MC&S
microscopy,
culture and
sensitivity
Urodynamic tests evaluate the storage of urine in the bladder and the flow of urine from the bladder through the urethra.[37] It may be performed in cases of incontinence or neurological problems affecting the urinary tract. However the American Urogynecologic Society does not recommend that urodynamics are part of initial diagnosis for uncomplicated overactive bladder.[38]
Ultrasound is routinely used in
urology. In a pelvic sonogram, organs of the pelvic region are imaged. This includes the
uterus and
ovaries or
urinary bladder. Males are sometimes given a pelvic sonogram to check on the health of their bladder, the
prostate, or their
testicles (for example to distinguish
epididymitis from
testicular torsion). In young males, it is used to distinguish more benign masses (
varicocele or
hydrocele) from
testicular cancer, which is highly curable but which must be treated to preserve health and fertility. There are two methods of performing a pelvic sonography – externally or internally. The internal pelvic sonogram is performed either trans
vaginally (in a woman) or transrectally (in a man). Sonographic imaging of the pelvic floor can produce important diagnostic information regarding the precise relationship of abnormal structures with other pelvic organs and it represents a useful hint to treat patients with symptoms related to pelvic prolapse, double incontinence and obstructed defecation. It is used to diagnose and, at higher frequencies, to treat (break up) kidney stones or kidney crystals (
nephrolithiasis).[39]
KUB stands for
Kidneys,
Ureters, and
Bladder. The projection does not necessarily include the diaphragm. The projection includes the entire urinary system, from the
pubic symphysis to the superior aspects of the kidneys. The
anteroposterior (AP) abdomen projection, in contrast, includes both halves of the diaphragm.[40][41] Despite its name, a KUB is not typically used to investigate pathology of the kidneys, ureters, or bladder, since these structures are difficult to assess (for example, the kidneys may not be visible due to overlying bowel gas.) In order to assess these structures radiographically, a technique called an
intravenous pyelogram was historically utilized, and today at many institutions CT urography is the technique of choice.[42]
CT urography (CTU) is commonly used in the evaluation of hematuria, and specifically tailored to image the renal collecting system, ureters and bladder in addition to the
renal parenchyma. Initial imaging includes a noncontrast phase to detect renal calculi as a source of hematuria. Note that dual energy CT may eventually allow the noncontrast phase to be eliminated. Contrast enhancement techniques for CTU vary from institution to institution. A common technique is a double bolus, single phase imaging algorithm. This technique is a hybrid contrast injection strategy that results in opacification of the renal parenchyma and the collecting system, ureters, and bladder. A small contrast bolus is administered initially, followed 10 minutes later with a larger bolus that is imaged in the corticomedullary phase. Excretory phase imaging allows for not only evaluation of the ureteral lumen, but also periureteral abnormalities including external masses and lymphadenopathy.[citation needed]
A
voiding cystogram is a functional study where contrast "dye" is injected through a catheter into the bladder. Under x-ray the radiologist asks the patient to void (usually young children) and will watch the contrast exiting the body on the x-ray monitor. This examines the child's bladder and lower urinary tract. Typically looking for
vesicoureteral reflux, involving urine backflow up into the kidneys.[45]
References
^
abc"Kidney Failure". National Institute of Diabetes and Digestive and Kidney Diseases. 2017-10-01. Retrieved 2019-06-17.
^
abLane, DR; Takhar, SS (August 2011). "Diagnosis and management of urinary tract infection and pyelonephritis". Emergency Medicine Clinics of North America. 29 (3): 539–52.
doi:
10.1016/j.emc.2011.04.001.
PMID21782073.
^Salvatore S, Salvatore S, Cattoni E, Siesto G, Serati M, Sorice P, Torella M (June 2011). "Urinary tract infections in women". European Journal of Obstetrics, Gynecology, and Reproductive Biology. 156 (2): 131–6.
doi:
10.1016/j.ejogrb.2011.01.028.
PMID21349630.
^Ackley, Betty (2010). Nursing diagnosis handbook : an evidence-based guide to planning care (9th ed.). Maryland Heights, Mo: Mosby.
ISBN9780323071505.
^Venes, Donald (2013). Taber's cyclopedic medical dictionary. Philadelphia: F.A. Davis.
ISBN9780803629776.
^Collins MM, Stafford RS, O'Leary MP, Barry MJ (1998). "How common is prostatitis? A national survey of physician visits". J. Urol. 159 (4): 1224–8.
doi:
10.1016/S0022-5347(01)63564-X.
PMID9507840.
^
abcdefghij"Urinary Retention". National Institute of Diabetes and Digestive and Kidney Diseases. Aug 2014.
Archived from the original on 4 October 2017. Retrieved 24 October 2017.
^Sliwinski, A; D'Arcy, FT; Sultana, R; Lawrentschuk, N (April 2016). "Acute urinary retention and the difficult catheterization: current emergency management". European Journal of Emergency Medicine. 23 (2): 80–8.
doi:
10.1097/MEJ.0000000000000334.
PMID26479738.
S2CID26988888.
^"Cancer Fact sheet N°297". World Health Organization. February 2014.
Archived from the original on 29 December 2010. Retrieved 10 June 2014.
^"Defining Cancer". National Cancer Institute. 17 September 2007.
Archived from the original on 25 June 2014. Retrieved 10 June 2014.
^Curti, B; Jana, BRP; Javeed, M; Makhoul, I; Sachdeva, K; Hu, W; Perry, M; Talavera, F (26 February 2014). Harris, JE (ed.).
"Renal Cell Carcinoma". Medscape Reference. WebMD.
Archived from the original on 7 March 2014. Retrieved 7 March 2014.
^"Prostate Cancer". National Cancer Institute. January 1980.
Archived from the original on 12 October 2014. Retrieved 12 October 2014.
^
abChowdhury SH, Cozma AI, Chowdhury JH. Urinary Tract Obstruction. Essentials for the Canadian Medical Licensing Exam: Review and Prep for MCCQE Part I. 2nd edition. Wolters Kluwer. Hong Kong. 2017.
^Po, Henry N.; Senozan, N. M. (2001). "The Henderson-Hasselbalch Equation: Its History and Limitations". Journal of Chemical Education. 78 (11). American Chemical Society (ACS): 1499.
Bibcode:
2001JChEd..78.1499P.
doi:
10.1021/ed078p1499.
ISSN0021-9584.
^Yetisen, Ali Kemal; Akram, Muhammad Safwan; Lowe, Christopher R. (2013-05-21). "Paper-based microfluidic point-of-care diagnostic devices". Lab on a Chip. 13 (12): 2210–2251.
doi:
10.1039/C3LC50169H.
ISSN1473-0189.
PMID23652632.
^Frank, Eugene D.; Long, Bruce W.; Smith, Barbara J. (2012). Merrill's Atlas of Radiographic Positioning & Procedures (12 ed.). St. Louis, MO: Mosby Inc.
ISBN978-0-323-07334-9.
^Bontrager, Kenneth L.; Lampignano, John P. (2005). Textbook of Radiographic Positioning and Related Anatomy (6 ed.). St. Louis, MO: Mosby, Inc.
ISBN978-0-323-02507-2.
^Frimberger, Dominic; Bauer, Stuart B.; Cain, Mark P.; Greenfield, Saul P.; Kirsch, Andrew J.; Ramji, Faridali; Mercado-Deane, Maria-Gisela; Cooper, Christoper S. (2016-12-01). "Establishing a standard protocol for the voiding cystourethrography". Journal of Pediatric Urology. 12 (6): 362–366.
doi:
10.1016/j.jpurol.2016.11.001.
ISSN1477-5131.
PMID27939178.
S2CID21041368.