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The urethra is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra connects to the urinary meatus above the vagina, whereas in marsupials, the female's urethra empties into the urogenital sinus.
The urinary bladder, or simply bladder, is a hollow muscular organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In the human the bladder is a hollow muscular, and distensible organ that sits on the pelvic floor. Urine enters the bladder via the ureters and exits via the urethra. The typical human bladder will hold between 300 and 500 ml before the urge to empty occurs, but can hold considerably more.
The urinary system, also known as the renal system or urinary tract, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, control levels of electrolytes and metabolites, and regulate blood pH. The urinary tract is the body's drainage system for the eventual removal of urine. The kidneys have an extensive blood supply via the renal arteries which leave the kidneys via the renal vein. Each kidney consists of functional units called nephrons. Following filtration of blood and further processing, wastes exit the kidney via the ureters, tubes made of smooth muscle fibres that propel urine towards the urinary bladder, where it is stored and subsequently expelled from the body by urination (voiding). The female and male urinary system are very similar, differing only in the length of the urethra.
Female ejaculation is characterized as an expulsion of fluid from or near the vagina during or before an orgasm. It is also known colloquially as squirting or gushing, although these are considered to be different phenomena in some research publications. Female ejaculation is physiologically distinct from coital incontinence, with which it is sometimes confused.
Urination is the release of urine from the urinary bladder through the urethra to the outside of the body. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, or, rarely, emiction, and known colloquially by various names including peeing, weeing, and pissing.
Urinary 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. It has been identified as an important issue in geriatric health care. The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis.
The Mitrofanoff procedure also known as the Mitrofanoff appendicovesicostomy, is a surgical procedure in which the appendix is used to create a conduit, or channel, between the skin surface and the urinary bladder. The small opening on the skin surface, or the stoma, is typically located either in the navel or nearby the navel on the right lower side of the abdomen. Originally developed by Professor Paul Mitrofanoff in 1980, the procedure represents an alternative to urethral catheterization and is sometimes used by people with urethral damage or by those with severe autonomic dysreflexia. An intermittent catheter, or a catheter that is inserted and then removed after use, is typically passed through the channel every 3-4 hours and the urine is drained into a toilet or a bottle. As the bladder fills, rising pressure compresses the channel against the bladder wall, creating a one-way valve that prevents leakage of urine between catheterizations.
Post-void dribbling occurs when urine remaining in the urethra after voiding the bladder slowly leaks out after urination. A common and usually benign complaint, it may be a symptom of urethral diverticulum, prostatitis and other medical problems.
Stress incontinence, also known as stress urinary incontinence (SUI) or effort incontinence is a form of urinary incontinence. It is due to inadequate closure of the bladder outlet by the urethral sphincter.
Neurogenic bladder dysfunction, or neurogenic bladder, refers to urinary bladder problems due to disease or injury of the central nervous system or peripheral nerves involved in the control of urination. There are multiple types of neurogenic bladder depending on the underlying cause and the symptoms. Symptoms include overactive bladder, urinary urgency, frequency, incontinence or difficulty passing urine. A range of diseases or conditions can cause neurogenic bladder including spinal cord injury, multiple sclerosis, stroke, brain injury, spina bifida, peripheral nerve damage, Parkinson's disease, or other neurodegenerative diseases. Neurogenic bladder can be diagnosed through a history and physical as well as imaging and more specialized testing. Treatment depends on underlying disease as well as symptoms and can be managed with behavioral changes, medications, surgeries, or other procedures. The symptoms of neurogenic bladder, especially incontinence, can have a significant impact on quality of life.
A pelvic examination is the physical examination of the external and internal female pelvic organs. It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract, such as pain, bleeding, discharge, urinary incontinence, or trauma. It can also be used assess a patient's anatomy in preparation for procedures. The exam can be done awake in the clinic and emergency department, or under anesthesia in the operating room. The most commonly performed components of the exam are 1) the external exam, to evaluate the external genitalia 2) the internal exam with palpation to examine the uterus, ovaries, and fallopian tubes, and 3) the internal exam using the speculum to visualize the vaginal walls and cervix. During the pelvic exam, sample of cells and fluids may be collected to screen for sexually transmitted infections or cancer.
The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the male or female external urethral sphincter and the internal urethral sphincter. When either of these muscles contracts, the urethra is sealed shut.
Cystometry, also known as flow cystometry, is a clinical diagnostic procedure used to evaluate bladder function. Specifically, it measures contractile force of the bladder when voiding. The resulting chart generated from cystometric analysis is known as a cystometrogram (CMG), which plots volume of liquid emptied from bladder against intravesical pressure.
Urodynamic testing or urodynamics is a study that assesses how the bladder and urethra are performing their job of storing and releasing urine. Urodynamic tests can help explain symptoms such as:
Urethral intercourse or coitus per urethram is sexual penetration of the female urethra by an object such as a penis or a finger. It is not the same thing as urethral sounding, the act of inserting a specialized medical tool into the urethra as a form of sexual or fetishistic activity.
Overflow incontinence is a form of urinary incontinence, characterized by the involuntary release of urine from an overfull urinary bladder, often in the absence of any urge to urinate. This condition occurs in people who have a blockage of the bladder outlet, or when the muscle that expels urine from the bladder is too weak to empty the bladder normally. Overflow incontinence may also be a side effect of certain medications.
An artificial urinary sphincter (AUS) is an implanted device to treat moderate to severe stress urinary incontinence, most commonly in men. The AUS is designed to supplement the function of the natural urinary sphincter that restricts urine flow out of the bladder.
Sebastian Wille is a German medical specialist, university professor and assistant medical director at the Clinic and Polyclinic of Urology at the University Hospital Cologne. Wille covers the whole diagnostic and therapeutic spectrum of urological disorders. His scientific focus is the reconstructive urology and the urological dysfunction of the lower urinary tract, including male and female incontinence. Wille was significantly involved in the invention of the Wille capsule.
Jerry Blaivas is an American urologist and senior faculty at the Icahn School of Medicine at Mount Sinai in New York City and adjunct professor of Urology at SUNY Downstate Medical School in Brooklyn, as well as professor of clinical urology at College of Physicians and Surgeons, Columbia University and clinical professor of Urology at Weill Medical College of Cornell University. He has four patents pending; received four research grants for which he served as the principal investigator; as of 2018 published 216 peer-reviewed articles, 14 books and 219 book chapters and served as a major in the United States Army assigned to the Walson Army Hospital. He served as president, Urodynamic Society.
A urethral bulking injection is a gynecological procedure and medical treatment used to treat involuntary leakage of urine: urinary incontinence in women. Injectional materials are used to control stress incontinence. Bulking agents are injected into the mucosa surrounding the bladder neck and proximal urethra. This reduces the diameter of the urethra and creates resistance to urine leakage. After the procedure, the pressure forcing the urine from the bladder through the urethra is resisted by the addition of the bulking agent in the tissue surrounding the proximal urethra. Most of the time this procedure prevents urinary stress incontinence in women.
References
- ↑ Bissada, N.K.; Finkbeiner, A.E. (1978). Lower urinary tract function and dysfunction: diagnosis and management. Appleton-Century-Crofts. ISBN 9780838556917 . Retrieved 2018-06-10.
- ↑ Chew, D.J.; DiBartola, S.P.; Schenck, P. (2010). Canine and Feline Nephrology and Urology - E-Book. Elsevier Health Sciences. ISBN 9781437723595 . Retrieved 2018-06-10.
- ↑ The Toronto Notes 2012: Comprehensive Medical Reference and Review for the Medical Council of Canada Qualifying Exam Part 1 and the United States Medical Licensing Exam Step 2. 2012. ISBN 9780980939774.
- ↑ Slack, M.; Culligan, P.; Tracey, M.; Hunsicker, K.; Patel, B.; Sumeray, M. (2004). "Relationship of urethral retro-resistance pressure to urodynamic measurements and incontinence severity". Neurourology and Urodynamics. 23 (2): 109–14. doi:10.1002/nau.20010. PMID 14983420.