This document provides an overview of the male and female urogenital systems. It describes the anatomy and functions of the kidneys, bladder, urethra, prostate, testes, ovaries, and other reproductive organs. It also discusses clinical examinations, common pathologies like urinary tract infections and prostate issues, and diagnostic tests. The male and female reproductive processes are outlined, from sperm and egg production through fertilization. Overall, the document serves as an introductory guide to the anatomy and clinical aspects of the urogenital system.

1. UROGENTAL SYSTEM
QURATULAIN MUGHAL
BATCH IV
DOCTOR OF PHYSICAL THERAPY
ISRA UNIVERSITY
1

2. CONTENTS
Male reproductive system
Urinary system of male and
female
Female reproductive
system
Clinical examination
Pathologies 2

3. UROGENITAL SYSTEM
 It’s a combination of urinary and reproductive
system.
3

4. MALE REPRODUCTIVE SYSTEM
4

5. TESTES
 Produce sperm
 Also known as testicles and gonads
5

6. VAS DEFERENS
 Transports mature sperm to the urethra
6

7. EPIDIDYMIS
 Sperm mature in epididymis
7

8. SEMINAL VESICLES
 Attached to vas deferens
 Produce a sugar rich fluid that provides energy to sperm
8

9. PROSTATE GLAND
 Makes fluid
9

10. URETHRA
 Tube that carries urine from the bladder to outside of the
body
 Also carries sperm out of the body
10

11. THE JOURNEY OF THE SPERM
 Testis
 Epididymis
 Vas deferen
 Semivesicals
 Prostate gland
 Urethra
 Penis
11

12. 12

13. PENIS
MALFORMATIONS
 Hypospadias
 the more common of the two conditions, the abnormal
opening of the urethra is on the ventral aspect of the
penis anywhere along the shaft
 Epispadias
 the abnormal urethral orifice is on the dorsal aspect of
the penis.
13

14. INFLAMMATORY LESIONS
Balanitis and balanoposthitis
 refer to local inflammation of the glans
penis and of the overlying prepuce,
respectively.
 Candida albicans, anaerobic bacteria,
Gardnerella, and pyogenic bacteria.
 poor local hygiene in uncircumcised
males, with accumulations of
desquamated epithelial cells, sweat, and
debris, termed smegma, acting as a
local irritant.
14

15. Phimosis
 condition in which the prepuce cannot be retracted
easily over the glans penis.
 most cases are acquired from scarring of the prepuce
secondary to previous episodes of balanoposthitis.
15

16. NEOPLASMS
 Squamous cell carcinoma in situ of the penis
 Bowendisease
 older uncircumcised males
 grossly as a solitary plaque on the shaft of the penis.
 Histologic examination reveals morphologically
malignant cells throughout the epidermis with no
invasion of the underlying stroma
16

17. CARCINOMA IN SITU (BOWEN DISEASE) OF THE PENIS. THE EPITHELIUM
ABOVE THE INTACT BASEMENT MEMBRANE SHOWS DELAYED MATURATION
AND DISORGANIZATION (LEFT). HIGHER MAGNIFICATION (RIGHT) SHOWS
SEVERAL MITOTIC FIGURES, SOME ABOVE THE BASAL LAYER, A
DYSKERATOTIC CELL, AND NUCLEAR PLEOMORPHISM.
17

18. PROSTATITIS
Categories:
acute bacterial prostatitis (2% to 5% of cases)
 caused by the same organisms associated with
other acute urinary tract infections
 is associated with fever, chills, and dysuria; it may
be complicated by sepsis. On rectal examination,
the prostate is exquisitely tender and boggy.
chronic bacterial prostatitis (2% to 5% of cases)
 also caused by common uropathogen
 is associated with recurrent urinary tract infections
bracketed by asymptomatic periods. Presenting
manifestations may include with low back pain,
dysuria, and perineal and suprapubic discomfort.
18

19. URINARY SYSTEM OF
MALE AND FEMALE
19

20. URINARY SYSTEM
 Kidneys (2)
 Most important excretory organ
 Eliminate waste
 Ureters (2)
 Bladder (1)
 Urethra (1)
 Nephron Unit
 Functional unit of the kidney
 Formation of urine
 Tubular and vascular structures
20

21. KIDNEY LOCATION AND
PROTECTION
 Kidneys are located in the posterior wall of the
abdominal cavity
 In the retroperitoneal space
 Connective tissue (renal fascia) hold the kidneys in
place
 Adipose tissue cushion the kidneys
 The lower rib cage partially enclose the kidney and
protect them
21

22. ANTERIOR/POSTERIOR
VIEWS
22

23. 23

24. KIDNEY STRUCTURES
Kidney is reddish-brown
Looks like a bean
Approximately 4 inches x 2 inches
Hilus – indentation where blood
vessels and structures enter or
exit the kidney
Three Regions in the kidney if
sliced in half – renal cortex, renal
medulla, renal pelvis 24

25. RENAL CORTEX
Light, outside region
Cortex means “bark”
25

26. RENAL MEDULLA
Dark, triangular structure
Form small cone shaped
regions called renal pyramids
Each pyramid is separated by
renal columns
The lower ends of the
pyramids point to the renal
pelvis
26

27. RENAL PELVIS
A basin that collects the urine
made by the kidney and helps
form the upper end of the ureter
The edges of the renal pelvis
closest to the renal pyramids are
called calyces
Calyces collect the urine formed in
the kidney 27

28. 28

29. HOW DO THEY WORK?
 Need a blood supply
 Brought to the kidney via the renal artery
 Renal artery stems from the abdominal aorta
 20-25% of cardiac output goes to the kidneys
 Smaller arteries supply blood to the nephron unit
 Blood leaves the kidney via the renal veins
 The renal veins empty into the inferior vena cava
29

30. FUNCTIONS OF THE KIDNEYS
 Excrete nitrogenous waste from the body
 Urea
 Ammonia
 Creatinine
 Regulate blood volume
 Help regulate electrolyte content of the blood
 Regulate acid-base balance (pH)
 Regulate blood pressure
 Regulates red blood cell production
30

31. THE FORMATION OF URINE
The Nephron Unit
Each kidney contains about 1 million
nephron units
The number does not increase after
birth
They cannot be replaced if damaged
2 parts
 Tubular component (renal tubule)
 Vascular component 31

32. RENAL TUBULES
Glomerular capsule (Bowman’s
Capsule) – “C” shaped capsule
surrounding the glomerulus
Glomerulus – cluster of capillaries
 Proximal convoluted tubule
 Loop of Henle – ascending and
descending limb
 Distal Convoluted tubule
 Collecting duct 32

33. 33

34. THREE PROCESSES ARE
INVOLVED IN URINE
FORMATION
 Glomerular filtration
 Tubular reabsorption
 Tubular secretion
34

35. 35

36. RENAL VASCULATURE
 Receives blood from the renal artery
 Renal artery branches into the afferent arterioles
 Afferent arterioles feed into Bowman’s capsule
 The efferent arterioles exit Bowman’s capsule
 The efferent arterioles form the peritubular
capillaries
 The peritubular capillaries empty into the
venules, large veins, and then into the renal
veins
 It is imperative you know the relationship
between the tubular and vascular structures.
36

37. COMPOSITION OF URINE
 Sterile
 95 % water
 Nitrogen containing waste – urea, uric acid,
ammonia, creatinine
 Electrolytes
 Light yellow color of urine is due to a pigment called
urochrome
 Urochrome is formed from the breakdown of
hemoglobin in the liver
37

38. URINE CHARACTERISTICS
 Amount – 1500 ml in 24 hours
 pH – average 6.0
 Color – yellow (amber, straw colored, concentrated,
orange, brown, red, sediment, clear or cloudy)
 Dehydrated = deep yellow, dark
 Overhydrated = pale yellow, colorless
38

39. ABNORMAL CONSTITUENTS OF URINE
 Albumin (protein)
 Glucose
 Red blood cells
 Hemoglobin
 White blood cells
 Ketone bodies
 Bilirubin
39

40. URINE TESTING
 Urinalysis
 Microscopic exam
 Culture and sensitivity
 Urine dipstick
 Urine Drug and alcohol screening
 24 hour urine testing
40

41. THE BLADDER
 Stores urine temporarily until elimination
 Located behind the symphasis pubis
 A distended bladder or full bladder can be
palpated above the syphasis in the abdominal
cavity.
 Bladder has 4 layers
 Mucous membrane
 Submucosa
 Detrusor muscle – involuntary smooth muscle
 Serosa
 Contain rugae to allow for stretching
 Trigone – triangular area in the floor of the
bladder 41

42. 42

43. URINATION – “MICTURITION”
 Expelling urine from the bladder
 The urge to urinate (void) happened at about 200
ml of urine in the bladder
 At about 300 ml urine in the bladder, the urge
becomes more uncomfortable
 Moderately full = 500 ml urine
 Overdistended bladder may have over 1000 ml
urine
 Bacteria in your bladder doubles every 4 hours.
 Stimulated by stretch receptors
43

44. URETHRA
 Carries urine from the bladder to the outside of the
body
 Internal sphincter prevents urine from emptying;
composed of smooth muscle; involuntary
 External sphincter at the upper portion of the
urethra allows you to resist the urge to urinate;
composed of skeletal muscle; voluntary
 Female – short, opens to the outside at the urethral
meatus
 Male – longer, passes through the prostate gland;
carries urine and sperm
44

45. 45

46. 46

47. URINARY RETENTION AND
SUPPRESSION
Retention - Inability to void
 Post operative; anesthesia
 Bladder dysfunction
Suppression – no urine formation
 Kidney dysfunction
47

48. DISORDERS OF THE URINARY SYSTEM
 Glomerulonephritis
 Polycystic Kidney
 Pyelonephritis
 Renal Calculi – kidney stones
 Renal Failure
 UTI – urinary tract infection
48

49. AS WE AGE
By age 80 there is a 50% reduction in
nephron units; therefore a decreased
ability to concentrate urine
Urinary bladder shrinks and becomes less
able to contract and relax; therefore the
elderly must void frequently
Bladder infection incidence increases
Increase in bladder incontinence due to
weakened muscles 49

50. SIGNS AND SYMPTOMS
 Urgency
 Frequency
 Burning sensation
 Hesitancy
 Genital pain
 Lesions
 Genital swelling
 Penile discharge
 Urinary symptoms 50

51. HISTORY
WHAT CAN THE HISTORY TELL YOU
ABOUT THE MALE GENITOURINARY
SYSTEM?
 Biographical data
 Current health status
 Past health history
 Family history
 Review of systems
 Psychosocial history
51

52. PHYSICAL ASSESSMENT
Anatomical landmarks: external--note position of
structures; internal-- visualize underlying structures
Approach: inspection, palpation
52

53. FEMALE REPRODUCTIVE
SYSTEM
53

54. VAGINA
 canal that joins the cervix to the outside of the
body
 also is known as the birth canal
54

55. UTERUS
 hollow organ that is the home to a developing
fetus
55

56. OVARIES
 produce eggs and hormones
 oval-shaped glands that are located on either
side of the uterus
56

57. FALLOPIAN TUBES
 tunnels for the egg cell to travel from the
ovaries to the uterus
 Where fertilization happens
57

58. THE JOURNEY OF THE EGG
CELL
 Ovary
 Fallopian tube
 Uterus
58

59. 59

60. PELVIC INFLAMMATORY
DISEASE
An inflammatory process
involving pathogenic invasion
of the fallopian tubes or
ovaries or both, as well as any
vascular or supporting
structures within the pelvis,
except the uterus. 60

61. SYMPTOMS
low-grade fever, pelvic pain,
abdominal pain, a “bearing
down backache, foul-smelling
vaginal discharge, nausea, etc.
Future infertility may develop
as complications
61

62. ENDOMETRIOSIS
during menstrual period,
endometrial cells are
stimulated by ovarian
hormone
Bleeding into surrounding
tissue occurs, causing
inflammation 62

63. SIGNS AND SYMPTOMS
 Discomforts of pelvic area before menses,
becoming worse during menstrual flow, and
diminishing as flow ceases .
 Fatigue
63

64. VAGINITIS
Inflammation of the vaginal mucosal
64

65. DYSMENORRHEA
Painful menstruation, also called
“menstrual cramps”
Signs and symptoms
 Subjective: headache, backache,
abdominal pain, chills, nausea
 Objective: fever, vomiting
65

66. AMENORRHEA
Absence of menstruation
66

67. COMMON DIAGNOSTIC TESTS
 Serum laboratory studies
 Luteinizing hormone (LH)
 Stimulates progesterone secretion
 Diminished levels may relate to prolonged, heavy
menses
 Elevated levels may result in short, scanty
menses
 Follicle-stimulating hormone (FSH)
 Stimulates estrogen secretion
 Diminished level may relate to bleeding between
cycles
 Elevated levels may result in excessive uterine
bleeding
67

68. COMMON DIAGNOSTIC TESTS
 Laparoscopy: visualization of the
pelvic structures with a lighted
laparoscope inserted through
the abdominal wall
 Culdoscopy: visualization of the
ovaries, fallopian tubes, and
fallopian tubes, and uterus with
a lighted instrument inserted
through the vaginal tract 68

69. Ultrasonography
 A sound frequency that reflects an
image of the pelvic structures
 An aid in confirming ovarian and
uterine tumors
69

70. 70

71. 71