Diseases of Urinary

System
Ayurveda Concepts

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System
Mutrakricchra

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Mutrakricchra

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Female Urethra

Has a single function:

to transport urine from the urinary bladder to the

vestibule, an external space immediately internal to
the labia minora

3 to 5 centimeters long, and opens to the

outside of the body at the external urethral
orifice located in the female perineum.

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Male Urethra

Urinary and reproductive functions:

passageway for both urine and semen

Approximately 18 to 20 centimeters long.
Partitioned into three segments:

prostatic urethra is approximately 3 to 4 centimeters long and is

the most dilatable portion of the urethra
extends through the prostate gland, immediately inferior to
the male bladder, where multiple small prostatic ducts enter it
membranous urethra is the shortest and least dilatable portion
extends from the inferior surface of the prostate gland through
the urogenital diaphragm
spongy urethra is the longest part (15 centimeters)
encased within a cylinder of erectile tissue in the penis called
the corpus spongiosum
extends to the external urethral orifice
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 Note etiologies
Inflammation of
mucosa
Trauma of
mucosa
Obstruction
Vesicoureteral
reflux
Immobility
Blood-borne
pathogens
TB
HIV
Septicemia

Mutrakricchra

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These result in:

Hydronephr
osis

Hydroureter
If these
conditions
exist longer
than 2 months
get destruction
of kidney

Major sites of urinary tract

obstruction

Mutrakricchra

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Mutrakricchra

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Mutraghata

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These result in:

Hydronephr
osis

Hydroureter
If these
conditions
exist longer
than 2 months
get destruction
of kidney

Major sites of urinary tract

obstruction

Obstructive Disorders

Renal Calculi

Etiology:
Calcium, Uric acid,
Urine crystals
Symptoms: renal colic,
N&V, chills, fever
Risk factors: prolong
dehydration, prolong
immobilization,
infection
Treatment:
surgery,lithotripsy

Anomalies

Strictures
Kinks
Ptosis
Pelvic kidney

Tumors

Note that primary

symptom = hematuria
Renal Cell Ca = most
common, unilateral,
adeno Ca from
tubular epithelium

See picture

Bladder Ca = usually
from transitional
epithelium

Neurogenic bladder

Congenital Diseases
Vesicoureteral reflux
Due to ectopic insertion of ureter into bladder. If
far away from trigone, do not get adequate
compression of ureter when voiding & get reflux
Incidence: 1/1000
If one gets it each sibling(to be) has 50%
incidence
Girls> boys; 10:1 ratio

Ectopic kidney
May get kinking of ureter
Usually in pelvis
Asymptomatic

Renal agenesis

Usually unilateral & left kidney

2 types: (1) occurs randomly (2) genetic
Asymptomatic
Remaining kidney becomes large since
compensatory hypertrophy

Congenital Diseases (cont)

Polycystic kidney

(2 types

In adults
(see picture)

Genetic etiol ----- autosomal dominant

Clinically seen in adults

Between age 30 40 one begins to
get renal failure

Tx = transplant
In children

Genetic etiol --- autosomal recessive

Manifest at birth; usually fatal or infant

stillborn
Rare

Wilms tumor (nephroblastoma)

Most common tumor of children; usually

unilateral
Etiol = autosomal recessive (on
chromosome 11)
Manifests between age 2 5 years &
presents as abdominal mass

May produce hypertension

5 year survival = 90%

Inflammatory disorders
(1) glomerulonephritis
(2) nephrotic syndrome

Glomerulonephritis
Acute
Sx = proteinuria, edema,
oliguria
Etiol = 1-2 weeks post
strept infect.
Chronic
Etiol = autoimmune disease

e.g. lupus, diabetes,

hepatitis C

Can lead to irreversible

kidney damage

 Nephrotic Syndrome
Glomerular disorder where one loses
the capacity to retain protein,
especially albumin
Sx
severe edema (anasarca)
* can get skin breakdown since
impaired arterial flow
proteinuria
hypoalbuminemia
oliguria
Etiol:
Toxic agents (lead, mercury)
Toxic drugs (aminoglycosides)
Diseases (diabetes, lupus
Key = any significant problem with
glomerulus can lead
to nephrotic syndrome

Renal Failure

Acute renal failure

Abrupt decrease in renal function

Nitrogenous wastes
accumulate
Usually reversible
Sx:

Oliguria

Drowsiness

Altered levels of
consciousness
Etiol:

Glomerular disease

Severe pyelonephritis

Nephrotoxins that damages

tubular epithelium

Ischemic causes

shock

ATN (acute tubular necrosis)

e.g. burns(hgb
accumulates)

e.g. trauma
(myoglobin
accumulates)

 Chronic Renal
Failure
Get slow
progressive loss of
neurons
Usually
irreversible
Course = gradual
Etiol:
Vascular
disease
e.g.
hypertensio
n
Disease
called
nephroscler
osis
Glomerular
disease

Hypertension & the

kidneys

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