29 Disorders of the Lower Urinary Tract Flashcards
Lower Urinary Tract
-transport urine formed by kidneys + allow removal fr the body
urine mvmt is due to…
effect of gravity + facilitation by peristaltic mvmt of ureters
urine is released through… by….
released thru the URETHRA
-requires integrity of ureters + bladder, competent urethral sphincters, functioning nervous system
Lower Urinary Tract
diagnostic tests
1 Urinalysis 2 Ultrasonography 3 Fluoroscopic Voiding Cystourethrography or Radionuclide Voiding Cystography 4 Urodynamic Testing
Urinalysis
for diagnosis of infection
Ultrasonography
visualization of urinary system
Fluoroscopic Voiding Cystourethrography or
Radionuclide Voiding Cystography
used to ID reflux or urethral abnormalities
Urodynamic Testing
used for diagnosing voiding dysfunctions
Micturition
urinating
- requires central, autonomic, + peripheral nervous system functioning
- result of parasympathetic + voluntary motor control
Mechanics of Micturition
nerve systems
RELAXATION + FILLING: bladder innervation is supplied by sympathetic nerves that exit spinal cords L1 + L2
BLADDER CONTRACTION + RELAXATION OF INTERNAL SPHINCTER: stim by parasympathetic nerves fr S1-S4
somatic pudendal nerve
innervates EXTERNAL bladder sphincter
sympathetic system
innervated blood vessels via hypogastric plexus
-resp for relaxation + filling
voiding dysfunctions may be SECONDARY to…
1 lower urinary tract disorders
2 pathologies affecting central, autonomic, + peripheral nervous system functioning
3 wide variety of factors affecting control of micturition (medication or access to toileting facilities)
Incontinence
lack of voluntary control over urination or defecation
3 tyopes of Incontinence
1 Urge Incontinence
2 Stress Incontinence
3 Mixed Incontinence
Urge Incontinence
- may be idiopathic
- due to bladder infection or radiation therapy
Stress Incontinence
-due to weakening of pelvic muscles or intrinsic
Mixed Incontinence
due to combination of stress + urge incontinence
Neurogenic bladder
broad classification of voiding dysfunction in which the specific cause is a pathology that produces a disruption of nervous communication
Voiding Dysfunction
treatment options
behavioral, pharmaceutical, + surgical
Bladder Cancer
- 4th most common cancer in males + 8th most common in females
- risk increases w age
- other risk factors: smoking + exposure to carcinogenic chemicals
where do most bladder cancer tumors originate?
UROEPITHELIUM (transitional epithelium ) lining the urinary tract
bladder cancer is primarily manifested as…
hematuria
-frequency + urgency may be present
Bladder Cancer
diagnostic
- cystoscopy
- tissue biopsy
- washings
Bladder Cancer
treatment
based on type, grade, + stage
- radiation
- chemo
- immunotherapy
