urology

Introduction
• Urology is a part of health care that
deals with diseases of the male and
female urinary tract (kidneys, ureters,
bladder and urethra). It also deals
with the male organs that are able to
make babies (penis, testes, scrotum,
prostate, etc.).

• Physician who specializes is called

as urologist
 Urinary system
• The urinary system's function is to filter blood and
create urine as a waste by-product. The organs
of the urinary system include the kidneys, renal
pelvis, ureters, bladder and urethra. The body
takes nutrients from food and converts them to
energy.

• The body takes nutrients from food and converts

them to energy. After the body has taken the food
components that it needs, waste products are left
behind in the bowel and in the blood.
 kidney
The kidney and urinary systems help
the body to eliminate liquid waste
called urea, and to keep chemicals,
such as potassium and sodium, and
water in balance.

Urea is produced when foods

containing protein, such as meat,
poultry, and certain vegetables, are
broken down in the body.

Urea is carried in the bloodstream to

the kidneys, where it is removed
along with water and other wastes in
the form of urine.
• Other important functions of
the kidneys include blood
pressure regulation and the
production of erythropoietin,
which controls red blood cell
production in the bone
marrow.

• Kidneys also regulate the

acid-base balance and
conserve fluids
• Two kidneys. This pair of
purplish-brown organs is located
below the ribs toward the middle
of the back. Their function is to:
• Remove waste products and
drugs from the body
• Balance the body's fluids
• Release hormones to regulate
blood pressure
• Control production of red
blood cells
• The kidneys remove urea from the blood through
tiny filtering units called nephrons.

• Each nephron consists of a ball formed of small

blood capillaries, called a glomerulus, and a small
tube called a renal tubule.

• Urea, together with water and other waste

substances, forms the urine as it passes through
the nephrons and down the renal tubules of the
kidney.
Ureters and urinary bladder
• Two ureters. These narrow
tubes carry urine from the kidneys to
the bladder.

• Muscles in the ureter walls

continually tighten and relax forcing
urine downward, away from the
kidneys.

• If urine backs up, or is allowed to

stand still, a kidney infection can
develop. About every 10 to 15
seconds, small amounts of urine are
emptied into the bladder from the
ureters.
• Bladder. This triangle-shaped,
hollow organ is located in the lower
abdomen. It is held in place by
ligaments that are attached to other
organs and the pelvic bones.

• The bladder's walls relax and

expand to store urine, and contract
and flatten to empty urine through
the urethra.

• The typical healthy adult bladder

can store up to two cups of urine for
two to five hours.
• Trigone: a triangle-shaped region near the
junction of the urethra and the bladder

• Right and left lateral walls: walls on either

side of the trigone

• Posterior wall: back wall

• Dome: roof of the bladder

• Two sphincter muscles. These circular

muscles help keep urine from leaking by
closing tightly like a rubber band around the
opening of the bladder.

• Nerves in the bladder. The nerves alert a

person when it is time to urinate, or empty
the bladder.
 urethra
• This tube allows urine to pass outside
the body. The brain signals the bladder
muscles to tighten, which squeezes
urine out of the bladder.

• At the same time, the brain signals the

sphincter muscles to relax to let urine
exit the bladder through the urethra.

• When all the signals occur in the correct

order, normal urination occurs.
Urine formation
• Basic structural unit of kidney is nephron
• Waste is excreted from the human body,
mainly in the form of urine. Our kidneys
play a major role in the process of
excretion.

• Constituents of normal human urine

include 95 per cent water and 5 per cent
solid wastes. It is produced in the
nephron, which is the structural and
functional unit of the kidney.
• Urine formation in our body is mainly
carried out in three phases namely

1.Glomerular filtration

2.Reabsorption

3.Secretion
Anatomy of nephron
• The anatomy of the nephron is important to
understand the urine formation process.
Each nephron is made up of two parts:

Renal Corpuscle Renal

Tubule
• The renal corpuscle is divided into the
glomerular capillaries or glomerulus
and the Bowman’s capsule. It is in the
renal corpuscle that the blood is
filtered at high pressure.
• The arteriole that brings blood into the
glomerulus is called the afferent
arteriole whereas the artery that takes
blood away from the glomerulus is
known as the efferent arteriole.
• Between these arterioles forms, a
network of capillaries called the
glomerular capillaries of the
glomerulus.
• The Bowman’s capsule is a cup-
shaped structure in which this
glomerulus is located. The glomerulus
along with the Bowman’s capsule
• The renal tubule consists of :
• The proximal convoluted Tubule(PCT)
• The U-shaped Loop Of Henle
• The Distal Convoluted Tubule(DCT)
• Once the blood is filtered in the
renal corpuscle, the resultant fluid is called
the glomerular filtrate. This glomerular filtrate
now passes into the PCT. In the
PCT, substances like NaCl, K+, water,
glucose, and bicarbonate are reabsorbed into
the filtrate whereas urea, creatinine, uric acid
are added to the filtrate.
• From the PCT, the filtrate enters the U-
shaped Loop of Henle where reabsorption
and secretion of water and various
metabolites occurs. The filtrate then passes
into the DCT. From the DCT, the filtrate
passes into the collecting tubules, into the
renal pelvis and the ureters as urine to be
 Glomerular filtration
• This process occurs in the
glomerular capillaries. The process of
filtration leads to the formation of an
ultrafiltrate.
• The blood gushes into these capillaries
with high pressure and gets filtered across
the thin capillary walls.
• Everything except the blood cells
and proteins are pushed into the capsular
space of the Bowman’s capsule to form the
ultrafiltrate.
• The glomerular filtration rate (GFR) is
125ml/min or 180 Liters/day.
 Tubular reabsorption
• During glomerular
filtration, all substances
except blood cells and
proteins are pushed
through the capillaries at
high pressure.
• At the level of the
Proximal Convoluted
Tubule(PCT), some of the
substances from the
filtrate are reabsorbed.
• These include sodium
chloride, potassium,
glucose, amino acids,
bicarbonate, and 75% of
water.
• Absorption of some substances is
passive, some substances are
actively transported while others
are co-transported.
• The absorption depends upon the
permeability of different parts of
the nephron.
• The distal convoluted tubule shows
selective absorption. The
substances and water which is
reabsorbed are taken up by the
peritubular capillaries to be
returned to the blood.
 Tubular secretion
• The peritubular capillaries that help
in transporting the reabsorbed
substances into the bloodstream,
also help in actively secreting
substances like H+ ions, K+ ions.
Whenever excess K+ is secreted
into the filtrate, Na+ ions are actively
reabsorbed to maintain the Na-K
balance.
• Some drugs are not filtered in the
glomerulus and so are actively
secreted into the filtrate during the
tubular secretion phase.
urine

The urine produced is 95% water and

5% nitrogenous wastes. Wastes such
as urea, ammonia, and creatinine are
excreted in the urine. Apart from
these, the potassium, sodium and
calcium ions are also excreted
Male reproductive system
• The purpose of the organs of the male
reproductive system is to perform the
following functions:
• To produce, maintain, and
transport sperm (the male reproductive cells)
and protective fluid (semen)
• To discharge sperm within the female
reproductive tract during sex
• To produce and secrete male sex hormones
responsible for maintaining the male
reproductive system
 SCROTUM
• this is the loose pouch-like sac of skin that
hangs behind and below the penis. It contains
the testicles (also called testes), as well as
many nerves and blood vessels. The scrotum
acts as a "climate control system" for the
testes.

• For normal sperm development, the testes

must be at a temperature slightly cooler than
body temperature.

• Special muscles in the wall of the scrotum allow

it to contract and relax, moving the testicles
closer to the body for warmth or farther away
from the body to cool the temperature.
 TESTES
• The 2 testes, also known as testicles, are the male
gonads responsible for the production of sperm
and testosterone. The testes are ellipsoid glandular
organs around 1.5 to 2 inches long and an inch in
diameter.

• Each testis is found inside its own pouch on one

side of the scrotum and is connected to the
abdomen by a spermatic cord and cremaster
muscle

• The epithelial cells contain many stem cells that

divide and form sperm cells through the process
of spermatogenesis.
EPIDIDYMIS
• The epididymis is a sperm storage area that
wraps around the superior and posterior edge
of the testes.
• The epididymis is made up of several feet of
long, thin tubules that are tightly coiled into a
small mass.
• Sperm produced in the testes moves into the
epididymis to mature before being passed on
through the male reproductive organs.
• The length of the epididymis delays the
release of the sperm and allows them time to
mature.
SPERMATIC CORDS AND DUCTUS DEFERENS

• Spermatic Cords and Ductus

Deferens
• Within the scrotum, a pair of
spermatic cords connects the testes
to the abdominal cavity. The
spermatic cords contain the ductus
deferens along with nerves, veins,
arteries, and lymphatic vessels that
support the function of the testes.
• The ductus deferens, also known as the vas
deferens, is a muscular tube that carries
sperm superiorly from the epididymis into
the abdominal cavity to the ejaculatory duct.

• The ductus deferens is wider in diameter

than the epididymis and uses its internal
space to store mature sperm.

• The smooth muscles of the walls of the

ductus deferens are used to move sperm
towards the ejaculatory duct through
peristalsis.
SEMINAL VESICLES
• The seminal vesicles are a pair of lumpy
exocrine glands that store and produce some of
the liquid portion of semen. The seminal
vesicles are about 2 inches in length and located
posterior to the urinary bladder and anterior to
the rectum.

• The liquid produced by the seminal vesicles

contains proteins and mucus and has an alkaline
pH to help sperm survive in the acidic
environment of the vagina. The liquid also
contains fructose to feed sperm cells so that they
survive long enough to fertilize the oocyte.
EJACULATORY DUCT
• The ductus deferens passes through the
prostate and joins with the urethra at a
structure known as the ejaculatory duct.

• The ejaculatory duct contains the ducts

from the seminal vesicles as well. During
ejaculation, the ejaculatory duct opens
and expels sperm and the secretions from
the seminal vesicles into the urethra.
URETHRA

◦ Semen passes from the ejaculatory duct to the exterior of the body via the
urethra, an 8 to 10 inch long muscular tube. The urethra passes through the
prostate and ends at the external urethral orifice located at the tip of the
penis. Urine exiting the body from the urinary bladder also passes through the
urethra.
PROSTATE
• The prostate is a walnut-sized exocrine gland that borders the inferior end of the
urinary bladder and surrounds the urethra. The prostate produces a large portion of the
fluid that makes up semen. This fluid is milky white in colour and contains enzymes,
proteins, and other chemicals to support and protect sperm during ejaculation. The
prostate also contains smooth muscle tissue that can constrict to prevent the flow of
urine or semen.
COWPER’S GLANDS
◦ Cowper’s Glands, also known as the bulbourethral glands, are a pair of pea-sized
exocrine glands located inferior to the prostate and anterior to the anus. The
Cowper’s glands secrete a thin alkaline fluid into the urethra that lubricates the
urethra and neutralizes acid from urine remaining in the urethra after urination.
This fluid enters the urethra during sexual arousal prior to ejaculation to prepare
the urethra for the flow of semen.
PENIS
• Penis is the male external sexual organ located superior to
the scrotum and inferior to the umbilicus. The penis is
roughly cylindrical in shape and contains the urethra and the
external opening of the urethra.

• Large pockets of erectile tissue in the penis allow it to fill

with blood and become erect. The erection of the penis
causes it to increase in size and become turgid.

• The function of the penis is to deliver semen into

the vagina during sexual intercourse. In addition to its
reproductive function, the penis also allows for the excretion
of urine through the urethra to the exterior of the body.
SEMEN
• Semen is the fluid produced by males for sexual reproduction and is ejaculated out of the body
during sexual intercourse.
• Semen contains sperm, the male reproductive gametes, along with a number of chemicals
suspended in a liquid medium. The chemical composition of semen gives it a thick, sticky
consistency and a slightly alkaline pH.
• These traits help semen to support reproduction by helping sperm to remain within the vagina
after intercourse and to neutralize the acidic environment of the vagina.
• In healthy adult males, semen contains around 100 million sperm cells per milliliter. These sperm
cells fertilize oocytes inside the female fallopian tubes.
SPERMATOGENESIS
• Spermatogenesis is the process of producing sperm and takes place in the testes
and epididymis of adult males. Prior to puberty, there is no spermatogenesis due
to the lack of hormonal triggers. At puberty, spermatogenesis begins when
luteinizing hormone (LH) and follicle stimulating hormone (FSH) are produced.
LH triggers the production of testosterone by the testes while FSH triggers the
maturation of germ cells. Testosterone stimulates stem cells in the testes known
as spermatogonium to undergo the process of developing into spermatocytes.
Each diploid spermatocyte goes through the process of meiosis I and splits into 2
haploid secondary spermatocytes. The secondary spermatocytes go through
meiosis II to form 4 haploid spermatid cells. The spermatid cells then go through
a process known as spermiogenesis where they grow a flagellum and develop the
structures of the sperm head. After spermiogenesis, the cell is finally a sperm
cell, or spermatozoa. The spermatozoa are released into the epididymis where
they complete their maturation and become able to move on their own.
 FERTILIZATION
• Fertilization is the process by which a sperm
combines with an oocyte, or egg cell, to produce a
fertilized zygote. The sperm released during
ejaculation must first swim through the vagina and
uterus and into the fallopian tubes where they may
find an oocyte. After encountering the oocyte,
sperm next have to penetrate the outer corona
radiata and zona pellucida layers of the oocyte.
Sperm contain enzymes in the acrosome region of
the head that allow them to penetrate these layers.
After penetrating the interior of the oocyte, the
nuclei of these haploid cells fuse to form a diploid
cell known as a zygote. The zygote cell begins cell
division to form an embryo.
pathology
pathology
procedures
Abbreviations