1. 14-1
URINE
Why do we clean our houses?
What do we do when we
clean our houses?
Don’t we throw out all
the waste and keep all
the useful things in
order?
Our body too does the same. It also cleans out the
waste in our body and keep only the useful things.
If our body did not do this, then all the waste would
collect, thus poisoning our bodies.
Urine is one waste from our body that we all
know very well. Let us learn how urine is made
and what are the parts in charge of this.

2. 14-2
URINE SYSTEM
Our Blood Gets Cleaned
Every 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 the
body that may cause harm. Through the urine that is produced, these things get thrown out of
the 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 System
1. Kidneys
We have two kidneys, one on each side of the body, and the right is a bit lower than the left. They
are 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 last
ribs 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 judging
It is about the size of the person’s fist. what needs to be kept and what should
be thrown out. For example, if we have
It 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 of
high 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 stricter
Only 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 not
vive, provided she does not work too hard. have to worry much about over eating !

3. 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 bladder
In each kidney, all the filters – or nephrons-
empty out and lead to a single tube that will
take the urine to the bladder. Drop by drop ureters
it is squeezed downwards through the two - takes urine from 2
tubes called ureter (you-re-ter) right to the kidneys to keep in the
bladder. bladder
3. Bladder - stores the urine bladder
- collects urine till
The bladder collects the urine that comes
quantity is enough
drop by drop and stores it. Only when the to throw out
urine collected gets to 150 ml –one cup – does
it ask the brain to look for a suitable time
and place to dispose it off. urethra
- tube that takes
prostrate glands urine from the
4. Urethra : Takes Urine Out of Body bladder to outside
- can get enlarged in
This is the tube that take urine from the blad- the body
men and decrease
der to throw it out of the body. In men, the flow of urine; needing
bladder empties out through the urethra that operation
passes through the length of the penis. In
women, the opening of the urethra is just
above the opening of the vagina (va-jye-nah ,
from where the baby comes out into the
world).
Prostrate Gland : In men, the urethra passes through a solid organ called the prostrate, which also
has an opening for the semen coming from the reproductive system. Both urine and the semen come out
at the tip of the urethra in the penis. The prostrate gland sometime gets enlarged - especially in older
men - and could decrease the flow of urine. It needs an operation to correct it.

4. 14-4
We Can Control Our Bladder Why cannot
Our bladder has a switch with control from the brain.
When enough urine is collected, signals from the brain
children
tell us to look for a proper place to throw it out. Till control their
then 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 small
two 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 valve
wait 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 than
our pants ! in girls. Some mental stress makes the
children insecure and they lose their
Pregnant women pass urine more often. This is bladder control. Sometimes, even
because 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 lose
control over the bladder valve. That is why old people may need bags to collect their
urine to prevent them from wetting all the time.
• In severe venereal or sexually transmitted infections like Gonorrhoea, the healing process
may 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 infections
You must have noticed that wher- Stones & Infections in Ureter or Urethra
ever 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 they
form a big mass and obstruct the If there are stones, usually the person has pain in the region
flow even further. The slower the where the urine flow has been blocked.
flow more is the collection of moss
and 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 from
urinary 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, urine
tends to collect there. More so, if the Stone in the Urethra
person 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 and
places, we tend to not only get infec- may always feel like emptying his bladder all the time.
tions but also stones.

5. 14-5
Signs of Urinary Infection
Shivering and fever are normally taken to be
signs 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 get
confused about whether it is malaria or a urine
infection. One way to check is to ask if the per-
son has pain or burning while passing urine. A
urine 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 chills
laria 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 of
and quite close to the anus (the the urine. If it is
opening for the shit to come out). more than straw
This makes it easy for all germs in colour, one needs to
our 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 melons
commonly. Burning sensation or which have up to
pain while passing urine with (or 95% water is as ef-
without) shivering and fever tells
fective as drinking
you 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.

6. 14-6
Know the Answers
Please 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.

7. 14-7
Diseases of Urine System
Most people find it very difficult and
embarassing to discuss diseases of the genital
and the urinary tract. Unless the interaction of
the health worker and the patient has a bit of
privacy, 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.

8. 14-8
Diseases of URINARY TRACT
1. Stones of the urinary tract
Stones 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 three
places 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 tract
a. If lodged inside the area of the kidney – c. If lodged in the urinary bladder – the
the person may face severe pain in the patient feels pain at the time of passing
loin (area of the back on both sides of urine and always feels like passing
the spine just where the rib cage ends) urine. Fresh blood may also be present
and/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 patient
nary 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 the
body).
How to detect stones in bladder?
Stones at a higher place earlier may pass downwards and the symptoms (problems) faced by the
person 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 or
Ultrasound that can rule them out.
Prevention of stone formation
Prevent stones by drinking plenty of water and fluids. Lots of flu-
ids and water, sufficient to remove any trace of colour from the
urine, not only prevents stones but may also be good enough to
flush 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 district
hospitals 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 the
urinary passage.
Complications. If not removed for long, stones may lead to bleeding
from the urinary tract and rarely even cancer.

9. 14-9
2. 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 UTIs
Lots and lots of fluids and water can flush out almost every infection from the
urinary 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 a
check up with a doctor should be considered.
If there is no relief in the burning sensation and fever within four doses of COTRIMOXAZOLE
in two days, another antibiotic like DOXYCYCLINE or CIPROFLOXACIN may be tried in
normal doses. Along with lots of water, some Soda Bicarbonate (Baking or Sweet Soda) may be
added. 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 and
feet. 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.

10. 14-10
Know the Answers
Diseases of Urine System
a. 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.