Urology studies the male and female genitourinary systems. The kidneys are retroperitoneal organs that filter blood to form urine. Each kidney contains nephrons, which are the functional filtering units. The ureters carry urine from the kidneys to the bladder. The bladder stores urine until urination. In males, the prostate surrounds the urethra where it exits the bladder. During urination, muscles in the bladder and urethra contract to expel urine from the body.

1. Urology
The subject of urology
Anatomy of the Human Urogenital System

2. Urology
Introduction
■ Urology studies :
■ Male genitourinary system
■ Woman's urinary system

3. The human kidney
General anatomical references
■ A pair of retroperitoneal organs
■ Weight: ~140 g (150 g. In men, 135 g. In women)
■ Size:
■ in length : 10-12 sm
■ in width : 5-7 sm
■ in thickness : 3 sm
■ Location
■ Projection to the spine column : T11-L3
■ Because of the inferior displacement of the right kidney by
the liver, the right kidney sits 1 to 2 cm lower than the left

4. ■ The medulla:
■ a darker inner region
■ Represented as pyramids
■ The apex of the
pyramids forms the
renal papilla - which is
cupped by an
individual minor calyx
■ The cortex:
■ a pale outer region
■ extends downward
between the individual
pyramids to form the
columns of Bertin
Kidney structure
parenchyma

5. Kidneys
Surface Anatomy and Relationships:
■ Renal (Gerota) fascia:
■ surrounded by a layer of condensed fat called the
paranephric fat and serves as an anatomic barrier to the
spread of malignancy
■ The Gerota fascia encasing the kidneys, adrenal glands,
and abdominal ureters is closed superiorly and laterally
■ Because it is open inferiorly, abnormal process may
spread to the pelvic cavity

7. Posterior relationships of the kidneys

8. Anterior relationships of the kidneys

10. Renal Vasculature
■ The renal arteries arise from the aorta at the level of the intervertebral
disk between the L1 and L2 vertebrae below the junction of the Superior
mesenteric artery.
■ The right renal artery passes behind the Inferior vena cava.

11. ■ Renal artery branches:
■ each artery divides into five segmental end arteries
that do not anastomose significantly with other
segmental arteries. Therefore occlusion or injury
to a segmental branch will cause segmental renal
infarction.
1. Interlobular arteries
2. arcuate arteries
3. afferent arterioles
4. glomerulus
5. efferent arterioles

13. ■ Renal Veins:
■ The renal venous drainage correlates closely
with the arterial supply
■ Vasa recta and the peritubular capillaries drain
into the renal vein
■ The renal veins drain into the Inferior Vena
Cava
■ The left renal vein receives the left suprarenal
(adrenal) vein and the left gonadal (testicular
or ovarian) vein
■ homonymous blood vessels on the right side
drains straight into the Inferior Vena Cava.

14. ■ Renal Vein
■ Renal Artery
■ Ureter
■ Renal artery and vein
located in front of
the pelvis of the
kidney and
proximally to the
Ureter
Hillum of the kidney, structures:

15. The Nephron - The functional unit of the kidney
■ The nephron (Bowman capsule, glomerulus)
■ tubules (Proximal convoluted tubule, Henle loop, Distal
convoluted tubule, Collecting tubule)

17. Functions of the kidneys and urinary tract
■ Excretion - by which metabolic waste is
eliminated from an organism. Participates in
whole-body homeostasis, regulating acid-base
balance, electrolyte concentrations, extracellular
fluid volume, and blood pressure
■ Endocrine
■ Synthesis of renin
■ Erythropoietin
■ Prostaglandins
■ Metabolic
■ Activation of Vit. D
■ Catabolism of hormones

18. Regulation of body fluid
■ The body fluid is divided :
■ Intracellular
■ Extracellular
■ Plasma
■ Intersticial fluid
■ Transcellular fluid

19. Osmoregulation and Osmotic Balance between cells and
environment

20. ■ Transmembrane transport of substances into the cell
■ Passive - is a movement of ions and other atomic or
molecular substances across cell membranes without need
of energy input
■ active - is the movement of molecules across a membrane
against the concentration gradient. Active transport
requires cellular energy to achieve this movement
■ Na+ - The most important Extracellular ion
■ K+ - The most important Intracellular ion

21. Kidney physiology
Urine formation
1. Filtering – Glomerular
2. Reabsorption - process by which
the nephron removes water and solutes from
the tubular fluid (pre-urine) and returns them to
the circulating blood
3. Secretion - The movement of substances from the
blood to the tubules through the cells (active
transport) or to the intercellular space (passive
transport)
4. Excretion - Movement of the final product resulting
from filtration, secretion and reabsorption into tubes

27. The Ureter
■ Length = 22-30 sm
■ Layers
■ Transitional epithelium
■ Lamina propria
■ Muscular layers
■ An inner longitudinal layer of muscle
■ An outer circular or spiral layer of muscle
■ Adventitia
■ containing blood vessels, lymphatic vessels, and veins

28. Anatomical relationships of the ureter
■ Started from the Ureteropelvic segment, which is located behind the
renal artery and vein, and then posteriorly, both ureters descend anterior
to the psoas major muscle
■ Anteriorly the right ureter separates to the ascending colon, appendix
and mesenterium of the colon.
■ The left ureter is in close relationship with descending colon, sigmoid
colon and their mesenteric shield.
■ Near the bladder, two-thirds of the ureter, the gonadal blood vessels
cross the ureter anteriorly
■ At the pelvic inlet, it crosses the common iliac vessels near their
bifurcation
■ The terminal ureter runs forward, accompanied by the neurovascular
bundle of the bladder and passes the anterior vaginal fornix just before
entering the bladder. This close proximity of the ureter to the uterine
vessels is the cause of ureteral injuries during gynecologic procedures.

30. Segmentation and Nomenclature
■ abdominal ureter - from the renal
pelvis to the pelvic brim
■ pelvic ureter - from the pelvic brim to
the bladder
■ intravesical or intramural ureter -
within the bladder wall
Blood supply and lymphatic drainage
■ Arterial branches approach medially
to the ureter in the abdominal cavity
■ In the pelvic cavity – Laterally
■ Upper segment of the ureter – From
branches of Renal artery, gonadal,
abdominal aorta and common iliac
arteries.
■ Distal ureter – Blood supply comes
laterally from the superior vesical
artery, a branch of the internal iliac
artery.

31. Urinary bladder
■ Hollow muscular organ
■ Capacity in Norm 450-500 ml.
■ Layers:
■ Mucosal – transitional epithelium
■ Connective tissue
■ Muscular tissue- Detrusor
■ The three openings, two ureteric orifices,
and the internal urethral orifice mark the
triangular area called the trigone of the
bladder.

33. Topographic Anatomy of the Male Urinary Bladder and Prostate

34. Prostate
■ Glandular and fibrotic-muscular organ
■ Normal prostate is about 20 gr.
■ Includes prostatic part of urethra(about 2.5
sm. length)
■ Ejaculatory ducts passes through
the prostate, and open into the uretra at
the seminal colliculus.

35. Transrectal biopsy of the prostate.
Benign prostatic hyperplasia

36. Prostate zonal anatomy:
• Transition zone - The most common site of
benign prostatic hyperplasia
• Peripheral zone - The most common place for
prostate cancer

37. Testicle and Epididymis
■ The average adult testicle size: 4 × 3 × 2.5 sm.

38. Penile and men’s urethra