14-1 URINEWhy do we clean our houses?What do we do when weclean our houses?Don’t we throw out allthe waste and keep allthe useful things inorder?Our body too does the same. It also cleans out thewaste in our body and keep only the useful things.If our body did not do this, then all the waste wouldcollect, thus poisoning our bodies.Urine is one waste from our body that we allknow very well. Let us learn how urine is madeand what are the parts in charge of this.
14-2 URINE SYSTEMOur Blood Gets CleanedEvery hour of our life, our blood gets cleaned not once but twice, by passing through the kid-neys. The two kidneys filter the blood. It cleans the blood of things which have collected in thebody that may cause harm. Through the urine that is produced, these things get thrown out ofthe body every now and then. The Urinary System two kidneys filter the blood urinary bladder where urine collects after getting filtered. Parts of the Urinary System1. KidneysWe have two kidneys, one on each side of the body, and the right is a bit lower than the left. Theyare located somewhere behind the stomach and upper intestine that we read earlier.If someone is lying with his chest down, you can feel the kidneys in the angle made by the lastribs and the spinal column. This is a dangerous place to hit anybody as the kidney can get dam-aged !How does the kidney Look? Our kidneys know best!The kidney looks like a kidney bean or rajma. Our two kidneys are clever in judgingIt is about the size of the person’s fist. what needs to be kept and what should be thrown out. For example, if we haveIt has numerous filters or nephrons (nef- eaten too many sweets, a lot of the glu-rawns) -– about twenty lakhs in both kidneys cose may be thrown out. If we have had— that can filter the blood very fast. Under a too much of meat and fruit juices, a lot ofhigh powered microscope, they look like big the potassium may need to be thrown out.headed worms with a twisted tail. On the other hand, if there were too lit- tle, the kidneys would try to be stricterOnly about five lakhs of nephrons – half a and save every bit of the glucose or po-kidney - are sufficient for a person to sur- tassium. Thanks to the kidney we do notvive, provided she does not work too hard. have to worry much about over eating !
14-3 How the Kidneys Clean the Blood Artery Takes the Blood to Kidney the veins An artery goes into either kidney and then carry the divides into smaller and smaller branches. Each of them can be filtered through one impure filter each. The filters (called Nephrons) are blood to very tiny but they do not allow any red cells the kidneys. or the proteins to pass through. Most of the fluid along with the salts and other waste material passes through. artery takes clean filtered Not All Fluid Is Thrown Out blood back to But this does not mean that all this gets the body. thrown out of our body. About 99% of this fluid along with vitamins, glucose and other The most important thing that the kidney important things gets reabsorbed. If this did has to filter and throw out is urea (you- not happen, we would have been passing ru-ya) after proteins are digested. If the about seven buckets of urine a day!! Only blood has more than its normal levels of urea, 1% of this fluid that the body does not need it acts like a poison on the body and the person is thrown out and is called urine. may die.2. Ureters - from kidney to bladderIn each kidney, all the filters – or nephrons-empty out and lead to a single tube that willtake the urine to the bladder. Drop by drop uretersit is squeezed downwards through the two - takes urine from 2tubes called ureter (you-re-ter) right to the kidneys to keep in thebladder. bladder3. Bladder - stores the urine bladder - collects urine tillThe bladder collects the urine that comes quantity is enoughdrop by drop and stores it. Only when the to throw outurine collected gets to 150 ml –one cup – doesit ask the brain to look for a suitable timeand place to dispose it off. urethra - tube that takes prostrate glands urine from the4. Urethra : Takes Urine Out of Body bladder to outside - can get enlarged inThis is the tube that take urine from the blad- the body men and decreaseder to throw it out of the body. In men, the flow of urine; needingbladder empties out through the urethra that operationpasses through the length of the penis. Inwomen, the opening of the urethra is justabove the opening of the vagina (va-jye-nah ,from where the baby comes out into theworld).Prostrate Gland : In men, the urethra passes through a solid organ called the prostrate, which alsohas an opening for the semen coming from the reproductive system. Both urine and the semen come outat the tip of the urethra in the penis. The prostrate gland sometime gets enlarged - especially in oldermen - and could decrease the flow of urine. It needs an operation to correct it.
14-4 We Can Control Our Bladder Why cannotOur bladder has a switch with control from the brain.When enough urine is collected, signals from the brain childrentell us to look for a proper place to throw it out. Till control theirthen it is stored in the bladder. If this switch was not bladder?there, we would have ended up dribbling out one or Babies have a smalltwo drops of urine into our clothes the whole day long! bladder capacity but this doubles by the age of four. A child learns to con-But our bladder cannot hold on forever. When you trol the opening of his lower valvewait on till 400ml or two glasses of urine gets col- around this age, but even then bed-lected, a valve like muscle at the lower end of the wetting is common.bladder can give way and we may pass urine and wet Bed-wetting is seen more in boys thanour pants ! in girls. Some mental stress makes the children insecure and they lose theirPregnant women pass urine more often. This is bladder control. Sometimes, evenbecause during the first three months and the last worms in the intestine can affect chil-two months, the urinary bladder gets very little dren’s control over their bladder.space to expand. Losing Control Over Our Bladder• Older people and those with damage to the spinal cord in an accident may losecontrol over the bladder valve. That is why old people may need bags to collect theirurine to prevent them from wetting all the time.• In severe venereal or sexually transmitted infections like Gonorrhoea, the healing processmay scar the urinary tract and cause blockade in the urine to flow.• Even a stone in the bladder may block the flow of urine. Stones and infectionsYou must have noticed that wher- Stones & Infections in Ureter or Urethraever a stream or a drain has a curve Stones once formed, will also lead to infection; and in-or an obstruction, the solid items fections in turn help stones to form.tend to collect there, and soon theyform a big mass and obstruct the If there are stones, usually the person has pain in the regionflow even further. The slower the where the urine flow has been blocked.flow more is the collection of mossand dirt. Stone in The Ureters If there is a stone in one of the ureters, the person will have Something similar happens with the squeezing pain on that side of the abdomen, starting fromurinary tract. If there is a bend in the just below the back of the chest and going towards the pri-tubes – ureters or the urethra – or vate parts – “loin to groin.”they have natural narrowing, urinetends to collect there. More so, if the Stone in the Urethraperson takes less water and the urine If the block is in the lower part of the bladder or the urethra,is thicker than normal. At these the person gets severe pain while trying to pass urine andplaces, we tend to not only get infec- may always feel like emptying his bladder all the time.tions but also stones.
14-5 Signs of Urinary InfectionShivering and fever are normally taken to besigns of malaria. But if a person has a urine in-fection she also gets chills and fever. So, when-ever a person has chills and fever, one can getconfused about whether it is malaria or a urineinfection. One way to check is to ask if the per-son has pain or burning while passing urine. Aurine test will show pus cells also. In areas with If there is infection with or without the stones,malaria, it may still be wise to give one day’s of ma- the person is likely to get fever with chillslaria treatment along with antibiotics to treat urine along with the pain.infection. Women are Drink loads of water to clear more prone urine infections to Urinary Infections 1. A good way to check if you are hav- 1. The women’s ing enough fluids is urethra (urine pipe) is short to see the colour ofand quite close to the anus (the the urine. If it isopening for the shit to come out). more than strawThis makes it easy for all germs in colour, one needs toour shit to be able to travel up the take even more flu-urine passage. Hence, women have ids. Eating cucum-infections of the urine tract very bers or melonscommonly. Burning sensation or which have up topain while passing urine with (or 95% water is as ef-without) shivering and fever tells fective as drinkingyou about infection in the urinary lots of water.tract. 2. Whenever there is a doubt about infection or stones in the urinary tract, we need to drink lots of fluids. Drinking much more than normal helps.
14-6 Know the AnswersPlease Fill in the blanks:1. Kidneys have lakhs of ______________, each of which filters the ______________.2. The urine from each kidney drips through the _________ to the ________________ where it is collected.3. Women get more urine infections because their ____________ is shorter and is close to the ____________________.4. Fever with _____________________ and pain from ______________ to ___________ warns us about urine infection.5. A normal person passes around __________ of urine every day.Please Mark whether “right” or “wrong”:1. As malaria can be confused with urinary infection, all cases of urinary infections must be given malaria treatment.2. As malaria can be confused with urinary infections, all cases of malaria infections must be given treatment for urinary infection.3. One must not eat cucumbers or water melons if there is a urinary problem.4. A stone in the ureters causes pain while trying to pass urine.5. Kidneys are partly covered by the ribs.
14-7Diseases of Urine SystemMost people find it very difficult andembarassing to discuss diseases of the genitaland the urinary tract. Unless the interaction ofthe health worker and the patient has a bit ofprivacy, many of such illnesses may be missed. Patients tell such illnesses to health workers in great confidentiality and it is her duty that it must not be discussed with others AT ANY COST.
14-8 Diseases of URINARY TRACT1. Stones of the urinary tractStones may result if the flow of urine is not possible freely, due to some abnormality in the per-son’s urinary passage since birth or after an illness/operation. Stones can lodge mainly at threeplaces and the problems that they may create depend on the site of passage that they block. Stones can be in different parts of the urinary tracta. If lodged inside the area of the kidney – c. If lodged in the urinary bladder – thethe person may face severe pain in the patient feels pain at the time of passingloin (area of the back on both sides of urine and always feels like passingthe spine just where the rib cage ends) urine. Fresh blood may also be presentand/or may get blood in the urine. in the urine.b. If lodged between the kidney and the uri- d. If lodged inside the penis – the patientnary bladder – the patient may face pain finds it difficult to pass urine and press-coming at short repeated intervals that ing on the penis may also be very pain-starts from the loin and goes to the left ful.or right groin (where the thigh joins thebody).How to detect stones in bladder?Stones at a higher place earlier may pass downwards and the symptoms (problems) faced by theperson may change over time. Although stones can be suspected by the symptoms as given above,usually stones can be seen by an X-Ray provided the person’s bowels have been cleared properly.However, some types of stones may not be seen on X-Ray, but there are other tests like IVU orUltrasound that can rule them out.Prevention of stone formationPrevent stones by drinking plenty of water and fluids. Lots of flu-ids and water, sufficient to remove any trace of colour from theurine, not only prevents stones but may also be good enough toflush them out. Drink lots of water to wash stones & infections away Treatment of stones in bladder. Apart from lots of fluids given for the next two to three months, giving drugs like ATROPINE and PARACETAMOL can lessen the pain of stones.The only other way is to remove the stones by surgery. Such operations can be done in districthospitals by either sending up a small tube through the penis or by opening the abdomen. Some-one who gets repeated stones must be checked for serious abnormality of the structure of theurinary passage. Complications. If not removed for long, stones may lead to bleeding from the urinary tract and rarely even cancer.
14-92. Urinary Tract Infections (UTIs)Just as the stones can be found in the urinary passage in various places, so can be the infections.Stones too can cause infections and can be often found together. Fever and shivering What happens in Urine Infections ?often come with urine Most infections cause fever. Very often this fever may be high and be accom- infections panied by shivering, confusing it with malaria. If there are stones along with fever, pain according to the locations as mentioned earlier may also be found. All infections of the urinary tract above the bladder may cause pain just as the stones in that part (see above). An infection at the inner end of the bladder or in the urethra may cause severe pain or a burning or irritating sensation while passing urine. Rarely, even blood in the urine may also be present along with infections of the urinary tract.Treating UTIsLots and lots of fluids and water can flush out almost every infection from theurinary tract. Apart from painkillers and fever reducing medicines, germ killers like antibiotics may be given. COTRIMOXAZOLE for seven to ten days continuously with lots of water will cure almost all infections. Although common in women, anyone getting an infection repeatedly should be checked for any problem inside her kidney or lower down - a Urine Test, X-Ray, etc., and acheck up with a doctor should be considered.If there is no relief in the burning sensation and fever within four doses of COTRIMOXAZOLEin two days, another antibiotic like DOXYCYCLINE or CIPROFLOXACIN may be tried innormal doses. Along with lots of water, some Soda Bicarbonate (Baking or Sweet Soda) may beadded. If that also fails to give relief, do refer a doctor. Some women may get repeated fevers – mild or high - without any burning sensation in the urine. It is important to rule out an infection of the urinary tract.CAUTION: Along with infections of the urinary tract, sometimes one notices swelling of the face andfeet. This tells us of the kidney getting affected. It needs urgent consultation with a doctor. As the reproductive tract is common to the urinary tract in parts, some of the diseases of the lower part of Urinary Tract can be seen in diseases of Reproductive Tract.
14-10 Know the Answers Diseases of Urine Systema. Please mark if “right” or “wrong” : 1. There is no difference in problems caused by stones and those in the urinary tract. 2. Stones in the urinary tract lead to squeezing pain but infections lead to pain along with fever and chills. 3. A stone at the mouth of the urethra in the bladder may cause pain while starting to urinate and the person feels like urinating all the time.b. Please fill in the blanks: 1. Urinary Tract Infection of the ureter causes : a. ____________________________________ b. ____________________________________ c. ____________________________________ 2. UTIs anywhere can be treated with lots of water, _______________ and painkillers. 3. Stones can be seen if an _______________ is done on the abdomen.