5.4 – Urinary Diseases, Disorders and Diagnostic Testing
Diabetic Nephropathy
Diabetic nephropathy impacts the kidneys as a result of having diabetes mellitus type 1 or 2. Higher levels of blood sugar can lead to high blood pressure, and this additional pressure exerted on the kidneys causes destruction of the small filtering structures within the kidney (Mayo Clinic Staff, 2019). To learn more about diabetic nephropathy, visit the Mayo Clinic’s Diabetic Nephropathy web page [New Tab].
Glomerulonephritis
Glomerulonephritis refers to acute or chronic nephritis that involves inflammation of the capillaries of the renal glomeruli. It has various causes, and is noted especially by blood or protein in the urine and by edema. If untreated, it could lead to kidney failure.
Hydronephrosis
Hydronephrosis is a condition whereby the kidneys begin to swell because of the retention of urine. Several conditions can cause hydronephrosis, such as a kidney stone or blood clot. Treatment will vary, depending on the cause (Cleveland Clinic, 2019). To learn more about hydronephrosis, visit the Cleveland Clinic’s web page on hydronephrosis [New Tab].
Polycystic Kidney Disease
Polycystic kidney disease (PKD) is a genetic disease where cysts grow inside the kidneys. The kidneys enlarge from the cystic collections, and damage to the filtering structures of the kidneys can occur. As the disease progresses, it may lead to chronic kidney disease (American Kidney Fund, 2020). To learn more, visit the Kidney Fund’s PKD web page [New Tab].
Renal Cell Carcinoma
Renal cell carcinoma is a cancer occurring in the kidney tubes where urine is produced or collected. This one of the most common cancers found within the kidneys. Removal of the cancerous lesions is the typical approach from a treatment perspective (Innovation for Patient Care, 2018). To learn more, visit Canadian Cancer Society’s page on kidney cancer [New Tab].
Renal Failure
Renal failure occurs when kidneys suddenly or gradually become unable to filter waste products from blood. When kidneys stop filtering, high level of wastes may build. Two types exist: acute kidney failure and chronic kidney failure (Mayo Clinic Staff, 2019a). To learn more about kidney failure, visit the Mayo Clinic’s page on Chronic Kidney Failure [New Tab].
Cystitis
Cystitis is inflammation of the urinary bladder, often caused by an infection. A chronic form of this condition is known as interstitial cystitis. Symptoms of cystitis include bladder pressure, voiding frequently, and pain (Mayo Clinic Staff, 2019b). To learn more about cystitis, visit the Mayo Clinic’s page on Interstitial Cystitis [New Tab].
Urinary Tract Infection
A urinary tract infection (UTI) is an infection caused by bacteria, or sometimes, fungi. The exact type of bacterial growth is determined by conducting urine for culture and sensitivity (C&S) testing. In rare cases, a UTI may be caused by a virus (Lights & Boskey, 2019). For more information, visit Healthline’s web page on Urinary Tract Infections [New Tab].
Urinary Incontinence
Urinary incontinence is a loss of bladder control. Those afflicted with the condition will experience urine leakage from the bladder. Weak bladder muscles are a risk factor for developing this condition (Kim & O’Connell, 2017). To learn more about this condition, visit Healthline’s webpage Urologic Diseases [New Tab].
Urinary Medical Terms in Use
Medical Terms in Context 1
Urinary System Operative Report (Text Version)
Fill in the consultation report with correct words listed below:
- Ureteral
- bladder
- recovery
- draped
- prepped
- fragmented
- lumen
- proximal
URINARY SYSTEM – OPERATIVE REPORT
PATIENT NAME: Cindy WARD
AGE: 48
DOB: September 19
SEX: Female
DATE OF SURGERY: January 8
SURGEON: Steve Foster, MD, Urologist
ASSISTANT: Michelle Stevenson, MD
ANESTHESIOLOGIST: Ryan Haywood, MD
ANESTHESIA: General
PREOPERATIVE DIAGNOSIS: Left proximal ureteral stones.
POSTOPERATIVE DIAGNOSIS: Left proximal ureteral calculi.
INDICATIONS: The patient is a 48-year-old female with a history of kidney stone disease, who has severe left flank pain and was found to have an obstructing large left proximal _____[Blank 1] stone.
OPERATIVE PROCEDURE: After induction of general anesthesia, the patient was placed in the lithotomy position. Patient was _____[Blank 2] and _____[Blank 3] in the usual sterile fashion. A #19-French cystoscope was inserted under camera vision. The urethra was unremarkable. The scope was passed into the bladder. The _____[Blank 4] mucosa was normal throughout. Under fluoroscopic control, a guidewire was placed up the left ureter and bypassed the stone. This was difficult at first, but the guidewire was eventually manipulated around the stone into the _____[Blank 5] collecting system. A rigid ureteroscope was then negotiated up the left ureter alongside the guidewire up to the stone, which was at the junction.
The stone was quite large and occupied the entire _____[Blank 6] of the ureter. Lithotripsy was then performed under camera vision. Using the Holmium laser, the stone was _____[Blank 7] into multiple fragments, all of which were then individually basketed. Some of the stones were sent for analysis. Further ureteroscopy up to the kidney failed to reveal any significant sized fragments. Therefore, the ureteroscope was removed.
The procedure was tolerated by the patient without complications. The patient was taken to the _____[Blank 8] room in stable condition.
________________________
Steve Foster, MD, Urologist
Note: Report samples (H5P and Pressbooks) are to encourage learners to identify correct medical terminology and do not represent the Association for Health Documentation Integrity (AHDI) formatting standards.
Check your answers:[1]
Activity source: Urinary System – Operative Report by Heather Scudder, licensed under CC BY 4.0./Text version added.
Medical Terms in Context 2
Urinary System Consultation Report (Text Version)
Fill in the consultation report with correct words listed below:
- Urine
- shortness
- pain
- leukorrhea
- dysuria
- foul
- urinalysis
- nausea
- UTIs
URINARY SYSTEM – CONSULTATION REPORT
PATIENT NAME: Renee WOODS
AGE: 32
SEX: Female
DOB: June 17
DATE OF CONSULTATION: January 8
CONSULTING PHYSICIAN: Steve Foster, MD, Urology
REASON FOR CONSULTATION: Urinary Tract Infection.
HISTORY: The patient is a 32-year-old female who is complaining of pain on urinating. Patient states it began approximately 3 days ago. The patient describes symptoms of _____[Blank 1] and increased frequency to the washroom. Patient states they usually go to the washroom to urinate 4-5 times a day, but starting 3 days ago, she started going 10-12 times per day. Sometimes no _____[Blank 2] comes out. The urine has a _____[Blank 3] odor and is cloudy. States there has been lower abdomen _____[Blank 4] since yesterday, and says it is worse when she tries to go with no result. Patient has had the same sexual partner for 10 years. She has a history of _____[Blank 5] and feels this is the same.
PHYSICAL EXAMINATION: GENERAL: No weakness, or tiredness. VITALS: Blood pressure 120/80, heart rate 70 and respirations 16. Patient weighs 150 pounds. LUNGS: No cough or _____[Blank 6] of breath. GASTRO: Denies _____[Blank 7], vomiting or change in bowel habits. URINARY/REPRODUCTIVE: Denies hematuria, or any _____[Blank 8].
ASSESSMENT: Did a urinalysis on patient. _____[Blank 9] revealed leukocytes 3+.
PLAN
- Treat with Ampicillin 400 mg q.i.d.
- Return to office if no improvement within 48 hours.
______________________________
Steve Foster, MD, Urology
Note: Report samples (H5P and Pressbooks) are to encourage learners to identify correct medical terminology and do not represent the Association for Health Documentation Integrity (AHDI) formatting standards.
Check your answers: [2]
Activity source: Urinary System Consultation Report by Heather Scudder and Sheila Bellefeuille, licensed under CC BY 4.0./Text version added.
Medical Specialties and Procedures Related to the Urinary System
Urology is a specialty that “addresses the medical and surgical treatment of disorders and diseases of the female urinary tract and the male urogenital system” (Canadian Medical Association, 2018). This specialty focuses on diagnosis, treatment, and surgical repair. Common clinical visits involve kidney stones, kidney failure, and bladder dysfunction. To learn more about urology as a specialty, visit the Urology Profile [PDF] authored by the Canadian Medical Association.
Urologist
A urologist is a medical specialist involved in the diagnosis and treatment of urinary and male genitourinary system conditions, disorders, and diseases such as prostate disease, renal and bladder dysfunctions, and others (Canadian Medical Association, 2019).
Procedures and Testing
Urinalysis
A urinalysis is a microscopic group of urine testing. This test detects and measures several substances in the urine, such as products of normal and abnormal metabolism and bacteria (Lab Tests Online, 2022). To learn more about urinalysis, visit Lab Tests Online’s Urinalysis web page [New Tab].
Urine for C&S
Urine for culture and sensitivity. Urine produced by the kidneys is analyzed by way of a urine culture test that can detect and identify bacteria in the urine, which may be causing a urinary tract infection (UTI). If harmful bacteria is found, a sensitivity report is generated. This report lists antibiotics sensitive in the treatment of the bacteria present (Lab Tests Online, 2020a). To learn more about Urine for C&S, visit Lab Tests Online’s Urine Culture web page [New Tab].
24 Hour Urine Collection
This is a test whereby all urinary output is collected over a 24-hour period of time. The analysis of urinary output over this extended period of time provides a greater indication of normal or abnormal kidney function (Lab Tests Online, 2017). To learn more, visit Johns Hopkins Medicine’s 24-hour Urine Collection article [New Tab].
CT Scan of Kidney
Computed tomography is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce a variety of images. It provides detailed images of the kidney looking for disease, cancer, obstructions and other kidney conditions (Johns Hopkins Medicine, n.d.) . To learn more about a CT scan of the kidney, visit Johns Hopkins Medicine’s page on Computed Tomography (CT or CAT) Scan of the Kidney [New Tab].
Cystoscopy
A cystoscopy is a procedure allowing a physician to check for bladder or ureteral problems, such as bladder cancer. An endoscope is used, also known as a cystoscope, containing a camera at the end of it (Canadian Cancer Society, 2020). To learn more about cystoscopy, visit the Canadian Cancer Society’s Cystoscopy and Ureteroscopy web page [New Page].
Dialysis
Dialysis is a treatment that removes waste products from the blood when the kidneys are not fully functioning. This type of therapy is available at home or in a hospital or clinic and there are two main types: peritoneal dialysis and hemodialysis (Kidney Foundation, 2020). To learn more about dialysis, visit the Kidney Foundation’s Dialysis web page [New Tab].
Intravenous Pyelogram
An intravenous pyelogram (IVP) is a specialized x-ray designed to produce views of the entire urinary tract. A dye is used to secure the enhanced imaging. The x-rays can also show how well the urinary tract is functioning and any identify any blockages (Canadian Cancer Society, 2020a). To learn more about IVP, visit the Canadian Cancer Society’s IVP web page [New Tab].
Kidney Scan
A kidney scan is an imaging test which views the kidneys. It is considered a nuclear imaging test, as it uses radioactive tracers to pick up hot or cold spots within the kidney. These variations are considered abnormal.
Kidney Transplant
When kidneys fail or when a person is in end stage chronic kidney disease, a surgical procedure is performed in the form of a kidney transplant. This procedure involves harvesting a donor kidney, which is transplanted into the recipient in need of a functioning kidney to support vital function of the urinary system.
Attribution
Except where otherwise noted, this chapter is adapted from “Urinary System” in Building a Medical Terminology Foundation by Kimberlee Carter and Marie Rutherford, licensed under CC BY 4.0. / A derivative of Betts et al., which can be accessed for free from Anatomy and Physiology (OpenStax). Adaptations: dividing Urinary System chapter content into sub-chapters.