CHAPTER I

INTRODUCTION

A. Background of The Paper

The urogenital system can be divided functionally into the urinary (excretory)
system and the genital (reproductive) system. Embryologically and anatomically,
however, they are closely connected. The urogenital system develops from the
intermediate mesoderm which extends along the dorsal body wall of the embryo.
The urinary system is composed of the kidneys, the ureters, the urinary bladder,
and the urethra. The kidneys maintain the proper volume and composition of the body's
fluids. The rest of the urinary system is specialized for the excretion or temporarily
storage of the urine.
The kidneys are essentially regulatory organs which maintain the volume and
composition of body fluid by filtration of the blood and selective reabsorption or
secretion of filtered solutes. The kidneys are retroperitoneal organs (ie located behind the
peritoneum) situated on the posterior wall of the abdomen on each side of the vertebral
column, at about the level of the twelfth rib. The left kidney is lightly higher in the
abdomen than the right, due to the presence of the liver pushing the right kidney down.
The kidneys take their blood supply directly from the aorta via the renal arteries;
blood is returned to the inferior vena cava via the renal veins. Urine (the filtered product
containing waste materials and water) excreted from the kidneys passes down the
fibromuscular ureters and collects in the bladder. The bladder muscle (the detrusor
muscle) is capable of distending to accept urine without increasing the pressure inside;
this means that large volumes can be collected (700-1000ml) without high-pressure
damage to the renal system occuring.When urine is passed, the urethral sphincter at the
base of the bladder relaxes, the detrusor contracts, and urine is voided via the urethra.
The genitourinary system, or urogenital system, is the organ system of the
reproductive organs and the urinary system. These are grouped together because of their
proximity to each other, their common embryological origin and the use of common
pathways, like the male urethra. Also, because of their proximity, the systems are
sometimes imaged together.

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B. Formulation of The Problem
1. How is the definition of genitourinary system?
2. How is the structure of genitourinary system?
3. How is the functions of genitourinary system?
4. How is the anatomy and physiology of genitourinary system?
5. How is the formation of urine?
6. What are disease and disorder of genitourinary system?
C. Purpose
1. Knowing the definition of genitourinary system,
2. Knowing the structure of genitourinary system,
3. Knowing the functions of genitourinary system
4. Knowing the anatomy and physiology of genitourinary system,
5. Knowing the formation of urine,
6. Knowing the disease and disorder of genitourinary system.

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 CHAPTER II

THEORY AND DISCUSSION

A. Definition of The Genitourinary System

Genitourinary is a word that refers to the urinary and genital organs, urology is
the branch of medicine concerned with the urinary tract in both genders and the genital
tract of the reproductive system in males. Nephrology is the branch of medicine
concerned with the kidney.
The urinary system, also known as the renal system or urinary tract, consists of
the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to
eliminate waste from the body, regulate blood volume and blood pressure, control levels
of electrolytes and metabolites, and regulate blood pH. The urinary tract is the body's
drainage system for the eventual removal of urine.
The kidneys have an extensive blood supply via the renal arteries which leave the
kidneys via the renal vein. Each kidney consists of functional units called nephrons.
Following filtration of blood and further processing, wastes (in the form of urine) exit the
kidney via the ureters, tubes made of smooth muscle fibres that propel urine towards the
urinary bladder, where it is stored and subsequently expelled from the body by urination
(voiding). The female and male urinary system are very similar, differing only in the
length of the urethra.
Urine is formed in the kidneys through a filtration of blood. The urine is then
passed through the ureters to the bladder, where it is stored. During urination, the urine is
passed from the bladder through the urethra to the outside of the body, 800–2,000
milliliters (mL) of urine are normally produced every day in a healthy human. This
amount varies according to fluid intake and kidney function.
The urinary tract includes the organ system primarily responsible for cleaning and
filtering excess fluid and waste material from the blood. The urinary system is comprised
of the following:
1) Kidneys
2) Ureters
3) Bladder

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 4) Urethra
The kidneys also function as glands that produce hormones necessary for building red
blood cells and regulating blood pressure.
B. Structure of The Genitourinary System
The urinary system refers to the structures that produce and transport urine to the
point of excretion. In the human urinary system there are two kidneys that are located
between the dorsal body wall and parietal peritoneum on both the left and right sides.
The formation of urine begins within the functional unit of the kidney, the
nephrons. Urine then flows through the nephrons, through a system of converging tubules
called collecting ducts. These collecting ducts then join together to form the minor
calyces, followed by the major calyces that ultimately join the renal pelvis. From here,
urine continues its flow from the renal pelvis into the ureter, transporting urine into the
urinary bladder.
The anatomy of the human urinary system differs between males and females at
the level of the urinary bladder. In males, the urethra begins at the internal urethral orifice
in the trigone of the bladder, continues through the external urethral orifice, and then
becomes the prostatic, membranous, bulbar, and penile urethra. Urine exits through the
external urethral meatus. The female urethra is much shorter, beginning at the bladder
neck and terminating in the vaginal vestibule.
C. Functions of The Genitourinary System
One of the major functions of the Urinary system is the process of excretion. Excretion is
the process of eliminating, from an organism, waste products of metabolism and other
materials that are of no use. The urinary system maintains an appropriate fluid volume by
regulating the amount of water that is excreted in the urine. Other aspects of its function
include regulating the concentrations of various electrolytes in the body fluids and
maintaining normal pH of the blood. Several body organs carry out excretion, but the
kidneys are the most important excretory organ. The primary function of the kidneys is to
maintain a stable internal environment (homeostasis) for optimal cell and tissue
metabolism. They do this by separating urea, mineral salts, toxins, and other waste
products from the blood. They also do the job of conserving water, salts, and electrolytes.

4
At least one kidney must function properly for life to be maintained. Six important roles
of the kidneys are:
1) Regulation of plasma ionic composition: Ions such as sodium, potassium, calcium,
magnesium, chloride, bicarbonate, and phosphates are regulated by the amount that
the kidney excretes.
2) Regulation of plasma osmolarity: The kidneys regulate osmolarity because they have
direct control over how many ions and how much water a person excretes.
3) Regulation of plasma volume: Your kidneys are so important they even have an effect
on your blood pressure. The kidneys control plasma volume by controlling how much
water a person excretes. The plasma volume has a direct effect on the total blood
volume, which has a direct effect on your blood pressure. Salt(NaCl)will cause
osmosis to happen; the diffusion of water into the blood.
4) Regulation of plasma hydrogen ion concentration (pH): The kidneys partner up with
the lungs and they together control the pH. The kidneys have a major role because
they control the amount of bicarbonate excreted or held onto. The kidneys help
maintain the blood Ph mainly by excreting hydrogen ions and reabsorbing
bicarbonate ions as needed.
5) Removal of metabolic waste products and foreign substances from the plasma: One of
the most important things the kidneys excrete is nitrogenous waste. As the liver
breaks down amino acids it also releases ammonia. The liver then quickly combines
that ammonia with carbon dioxide, creating urea which is the primary nitrogenous
end product of metabolism in humans. The liver turns the ammonia into urea because
it is much less toxic. We can also excrete some ammonia, creatinine and uric acid.
The creatinine comes from the metabolic breakdown of creatine phospate (a high-
energy phosphate in muscles). Uric acid comes from the break down of nucleotides.
Uric acid is insoluble and too much uric acid in the blood will build up and form
crystals that can collect in the joints and cause gout.
6) Secretion of Hormones: The endocrine system has assistance from the kidney's when
releasing hormones. Renin is released by the kidneys. Renin leads to the secretion of
aldosterone which is released from the adrenal cortex. Aldosterone promotes the
kidneys to reabsorb the sodium (Na+) ions. The kidneys also secrete erythropoietin

5
 when the blood doesn't have the capacity to carry oxygen. Erythropoietin stimulates
red blood cell production. The Vitamin D from the skin is also activated with help
from the kidneys. Calcium (Ca+) absorption from the digestive tract is promoted by
vitamin D.

The main functions of the urinary system and its components are to:

1) Regulate blood volume and composition (e.g. sodium, potassium and calcium)
2) Regulate blood pressure.
3) Regulate pH homeostasis of the blood.
4) Contributes to the production of red blood cells by the kidney.
5) Helps synthesize calcitrol the (active form of Vitamin D).
6) Stores waste product (mainly urea and uric acid) before it and other products are
removed from the body.
D. Anatomy and Physiology of Genitourinary System

The urinary system consists of the kidneys, ureters, urinary bladder, and urethra. The
kidneys filter the blood to remove wastes and produce urine. The ureters, urinary bladder,
and urethra together form the urinary tract, which acts as a plumbing system to drain
urine from the kidneys, store it, and then release it during urination. Besides filtering and

6
eliminating wastes from the body, the urinary system also maintains the homeostasis of
water, ions, pH, blood pressure, calcium and red blood cells.
1) Anatomy of Genitourinary System:
a) Kidneys

The kidneys are two bean-shaped organs found in vertebrates. They are
located on the left and right in the retroperitoneal space, and in adult humans are
about 11 centimetres (4.3 in) in length. They receive blood from the paired renal
arteries; blood exits into the paired renal veins. Each kidney is attached to a
ureter, a tube that carries excreted urine to the bladder.
The nephron is the structural and functional unit of the kidney. Each
human adult kidney contains around 1 million nephrons, while a mouse kidney
contains only about 12,500 nephrons. The kidney participates in the control of the
volume of various body fluid compartments, fluid osmolality, acid-base balance,
various electrolyte concentrations, and removal of toxins. Filtration occurs in the
glomerulus: one-fifth of the blood volume that enters the kidneys is filtered.
Examples of substances reabsorbed are solute-free water, sodium, bicarbonate,

7
glucose, and amino acids. Examples of substances secreted are hydrogen,
ammonium, potassium and uric acid. The kidneys also carry out functions
independent of the nephron. For example, they convert a precursor of vitamin D
to its active form, calcitriol; and synthesize the hormones erythropoietin and
renin.
Renal physiology is the study of kidney function. Nephrology is the
medical specialty which addresses diseases of kidney function: these include
chronic kidney disease, nephritic and nephrotic syndromes, acute kidney injury,
and pyelonephritis. Urology addresses diseases of kidney (and urinary tract)
anatomy: these include cancer, renal cysts, kidney stones and ureteral stones, and
urinary tract obstruction.
Procedures used in the management of kidney disease include chemical
and microscopic examination of the urine (urinalysis), measurement of kidney
function by calculating the estimated glomerular filtration rate (eGFR) using the
serum creatinine; and kidney biopsy and CT scan to evaluate for abnormal
anatomy. Dialysis and kidney transplantation are used to treat kidney failure; one
(or both sequentially) of these are almost always used when renal function drops
below 15%. Nephrectomy is frequently used to cure renal cell carcinoma.

Structure and Function of Kidneys :

In humans, the kidneys are located high in the abdominal cavity, one on
each side of the spine, and lie in a retroperitoneal position at a slightly oblique
angle.The asymmetry within the abdominal cavity, caused by the position of the
liver, typically results in the right kidney being slightly lower and smaller than the
left, and being placed slightly more to the middle than the left kidney. The left
kidney is approximately at the vertebral level T12 to L3, and the right is slightly
lower. The right kidney sits just below the diaphragm and posterior to the liver.
The left sits below the diaphragm and posterior to the spleen. On top of each
kidney is an adrenal gland. The upper parts of the kidneys are partially protected
by the 11th and 12th ribs. Each kidney, with its adrenal gland is surrounded by

8
 two layers of fat: the perirenal fat present between renal fascia and renal capsule
and pararenal fat superior to the renal fascia.
The kidney is a bean-shaped structure with a convex and a concave
border. A recessed area on the concave border is the renal hilum, where the renal
artery enters the kidney and the renal vein and ureter leave. The kidney is
surrounded by tough fibrous tissue, the renal capsule, which is itself surrounded
by perirenal fat, renal fascia, and pararenal fat. The anterior (front) surface of
these tissues is the peritoneum, while the posterior (rear) surface is the
transversalis fascia.
The kidneys excrete a variety of waste products produced by metabolism
into the urine. The microscopic structural and functional unit of the kidney is the
nephron. It processes the blood supplied to it via filtration, reabsorption, secretion
and excretion; the consequence of those processes is the production of urine.
These include the nitrogenous wastes urea, from protein catabolism, and uric acid,
from nucleic acid metabolism. The ability of mammals and some birds to
concentrate wastes into a volume of urine much smaller than the volume of blood
from which the wastes were extracted is dependent on an elaborate countercurrent
multiplication mechanism. This requires several independent nephron
characteristics to operate: a tight hairpin configuration of the tubules, water and
ion permeability in the descending limb of the loop, water impermeability in the
ascending loop, and active ion transport out of most of the ascending limb. In
addition, passive countercurrent exchange by the vessels carrying the blood
supply to the nephron is essential for enabling this function.
The kidney participates in whole-body homeostasis, regulating acid-base
balance, electrolyte concentrations, extracellular fluid volume, and blood
pressure. The kidney accomplishes these homeostatic functions both
independently and in concert with other organs, particularly those of the
endocrine system. Various endocrine hormones coordinate these endocrine
functions; these include renin, angiotensin II, aldosterone, antidiuretic hormone,
and atrial natriuretic peptide, among others.
b) Ureters

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In human anatomy, the ureters are tubes made of smooth muscle fibers that propel
urine from the kidneys to the urinary bladder. In the adult, the ureters are usually 25–
30 cm (10–12 in) long and around 3–4 mm (0.12–0.16 in) in diameter. Histologically,
the ureter is lined by the urothelium, a type of transitional epithelium, and has an
additional smooth muscle layer in the more distal one-third to assist with peristalsis.
The ureter is a muscular tube, 25 to 30 cm in length. It descends in the
retroperitoneum downward and medially in front of the psoas muscle, opposite the
tips of the lumbar transverse processes up to the pelvic brim, where it crosses over the
end of the common iliac artery or the beginning of the external iliac artery. The ureter
then runs along the lateral pelvic wall until it reaches the level of the ischial spine,
where it courses anterior and medially to enter the urinary bladder at its posterior
inferior surface at the vesicoureteral junction. The ureter has three areas of relative
narrowing in its course. These are common sites for stone impaction: at the

10
pelviureteric junction, where it crosses the pelvic brim and at the ureterovesical
junction.
Structure and Function of Ureters :
In humans, the ureters arise from the pelvis of each kidney, and descend on top of the
psoas major muscle to reach the brim of the pelvis. Here, they cross in front of the
common iliac arteries. They then pass down along the sides of the pelvis, and finally
curve forwards and enter the bladder from its left and right sides at the back of the
bladder. This is classically depicted as running "posteroinferiorly on the lateral walls
of the pelvis and then curve anteromedially to enter the bladder". The orifices of the
ureters are placed at the postero-lateral angles of the trigone of the bladder, and are
usually slit-like in form. In the contracted bladder they are about 25 mm (1 in) apart
and about the same distance from the internal urethral orifice; in the distended
bladder these measurements may be increased to about 50 mm (2 in).

The junction between the pelvis of the kidney and the ureters is known as the
ureteropelvic junction or ureteral pelvic junction, and the junction between the ureter
and the bladder is known as the ureterovesical (ureter-bladder) junction. At the
entrance to the bladder, the ureters are surrounded by valves known as ureterovesical
valves, which prevent vesicoureteral reflux (backflow of urine).

In females, the ureters pass through the mesometrium and under the uterine arteries
on the way to the urinary bladder.

The ureter has a diameter of 3 mm (0.12 in) but there are three constrictions, which
are the most common sites of renal calculus obstruction:
1) At the pelvi-ureteric junction (PUJ) of the renal pelvis and the ureter
2) As the ureter enters the pelvis and crosses over the common iliac artery
bifurcation
3) At the vesicoureteric junction (VUJ) as the ureter obliquely enters the bladder
wall

11
The ureters are a component of the urinary system. Urine, produced by the kidneys,
travels along the ureters to the bladder.

c) The Urinary Bladder

The urinary bladder lies in the pelvis with the peritoneum covering only its
superior surface. On its posterior surface, the ureters pass through the bladder wall
for 2 cm in an oblique course before they open into the urinary bladder cavity by
slitlike apertures.
The urinary bladder is a hollow muscular organ in humans and some other
animals that collects and stores urine from the kidneys before disposal by
urination. In the human the bladder is a hollow muscular, and distensible (or
elastic) organ, that sits on the pelvic floor. Urine enters the bladder via the ureters
and exits via the urethra. The typical human bladder will hold between 300 and
500 mL (10.14 and 16.91 fl oz) before the urge to empty occurs, but can hold
considerably more.

Structure and Function of The Urinary Bladder :

In humans, the bladder is a hollow muscular organ situated at the base of the
pelvis. Urine collects in the bladder, fed from the two ureters that connect the

12
bladder with the kidneys. Urine leaves the bladder via the urethra, a single
muscular tube ending in an opening – the urinary meatus, where it exits the body.

Anatomists divide the bladder into:

1) A broad fundus
2) A body
3) An apex
4) A neck
The apex (prev.vertex) is directed forward toward the upper part of the pubic
symphysis, and from there the median umbilical ligament continues upward on
the back of the anterior abdominal wall to the umbilicus. The peritoneum is
carried by it from the apex on to the abdominal wall to form the middle umbilical
fold.
The neck of the bladder is the area at the base of the trigone that surrounds the
internal urethral orifice that leads to the urethra. In males the neck of the urinary
bladder is adjacent to the prostate gland.
The three openings, two ureteric orifices, and the internal urethral orifice mark the
triangular area called the trigone of the bladder. These openings have mucosal
flaps in front of them that act as valves in preventing the backflow of urine into
the ureters, known as vesicoureteral reflux. Between the two ureteric openings is a
raised area of tissue called the interureteric crest. This makes the upper boundary
of the trigone. The trigone is a smooth-muscle area that forms the floor of the
bladder above the urethra. It is an area of smooth tissue for the easy flow of urine
into and from this part of the bladder - in contrast to the irregular surface formed
by the rugae.
In men, the prostate gland lies outside the opening for the urethra. The middle
lobe of the prostate causes an elevation in the mucous membrane behind the
internal urethral orifice called the uvula of urinary bladder. The uvula can enlarge
when the prostate becomes enlarged.
The bladder is situated below the peritoneal cavity near the pelvic floor and
behind the pubic symphysis. In men, it lies in front of the rectum, separated by the

13
 recto-vesical pouch, and is supported by fibres of the levator ani and of the
prostate gland. In women, it lies in front of the uterus, separated by the vesico-
uterine pouch, and is supported by the elevator ani and the upper part of the
vagina. The wall of the urinary bladder is normally 3–5 mm thick.When well
distended, the wall is normally less than 3 mm.
The inner walls have a series of ridges, thick mucosal folds known as rugae that
allow for the expansion of the bladder.
The Latin phrase for "urinary bladder" is vesica urinaria, and the term vesical or
prefix vesico - appear in connection with associated structures such as vesical
veins. The modern Latin word for "bladder" - cystis - appears in associated terms
such as cystitis (inflammation of the bladder).
Urine, excreted by the kidneys, collects in the bladder before disposal by urination
(micturition). The urinary bladder usually holds 300-350 ml of urine. As urine
accumulates, the rugae flatten and the wall of the bladder thins as it stretches,
allowing the bladder to store larger amounts of urine without a significant rise in
internal pressure.[20] Urination is controlled by the pontine micturition center in
the brainstem.
d) Urethral

In anatomy, the urethra (from Greek οὐρήθρα – ourḗthrā) is a tube that connects
the urinary bladder to the urinary meatus for the removal of urine from the body.
In males, the urethra travels through the penis and also carries semen. In human
females and other primates, the urethra connects to the urinary meatus above the

14
vagina, whereas in marsupials, the female's urethra empties into the urogenital
sinus.
Females use their urethra only for urinating, but males use their urethra for both
urination and ejaculation. The external urethral sphincter is a striated muscle that
allows voluntary control over urination. The internal sphincter, formed by the
involuntary smooth muscles lining the bladder neck and urethra, is innervated by
the sympathetic division of the autonomic nervous system. The internal sphincter
is present both in males and females.
1) Anatomy
 Male
In the human male, the urethra is about 8 inches (20 cm) long and
opens at the end of the external urethral meatus. The urethra provides
an exit for urine as well as semen during ejaculation.
The urethra is divided into four parts in men, named after the location:
Region Description Epithelium
Pre-prostatic This is the intramural part of the Transitional
Urethra urethra and varies between 0.5
and 1.5 cm in length depending
on the fullness of the bladder.
Prostatic Crosses through the prostate Transitional
Urethra gland. There are several
openings: (1) the ejaculatory
duct receives sperm from the vas
deferens and ejaculate fluid from
the seminal vesicle, (2) several
prostatic ducts where fluid from
the prostate enters and
contributes to the ejaculate, (3)
the prostatic utricle, which is
merely an indentation. These
openings are collectively called

15
 the verumontanum.
Membranous A small (1 or 2 cm) portion Pseudostratified
Urethra passing through the external Columnar
urethral sphincter. This is the
narrowest part of the urethra. It
is located in the deep perineal
pouch. The bulbourethral glands
(Cowper's gland) are found
posterior to this region but open
in the spongy urethra.
Spongy Runs along the length of the Pseudostratified
Urethra or penis on its ventral (underneath) Columnar – Proximally,
Penile Urethra surface. It is about 15–16 cm in Stratified Squamous –
length, and travels through the Distally
corpus spongiosum. The ducts
from the urethral gland (gland of
Littre) enter here. The openings
of the bulbourethral glands are
also found here.[9] Some
textbooks will subdivide the
spongy urethra into two parts,
the bulbous and pendulous
urethra. The urethral lumen runs
effectively parallel to the penis,
except at the narrowest point, the
external urethral meatus, where
it is vertical. This produces a
spiral stream of urine and has the
effect of cleaning the external
urethral meatus. The lack of an
equivalent mechanism in the

16
 female urethra partly explains
why urinary tract infections
occur so much more frequently
in females.

 Female
In the human female, the urethra is about 1.9 inches (4.8 cm) to 2
inches (5.1 cm) long and exits the body between the clitoris and the
vagina, extending from the internal to the external urethral orifice. The
meatus is located below the clitoris. It is placed behind the symphysis
pubis, embedded in the anterior wall of the vagina, and its direction is
obliquely downward and forward; it is slightly curved with the
concavity directed forward. The proximal 2/3rds is lined by
transitional epithelium cells while distal 1/3rd is lined by stratified
squamous epithelium cells.
The urethra consists of three coats: muscular, erectile, and mucous,
the muscular layer being a continuation of that of the bladder. Between
the superior and inferior fascia of the urogenital diaphragm, the female
urethra is surrounded by the urethral sphincter. Somatic (conscious)
innervation of the external urethral sphincter is supplied by the
pudendal nerve.
2) Physiology
The urethra is the vessel through which urine passes after leaving the
bladder. During urination, the smooth muscle lining the urethra relaxes in
concert with bladder contraction(s) to forcefully expel the urine in a
pressurized stream. Following this, the urethra re-establishes muscle tone by
contracting the smooth muscle layer, and the bladder returns to a relaxed,
quiescent state. Urethral smooth muscle cells are mechanically coupled to
each other to coordinate mechanical force and electrical signaling in an
organized, unitary fashion.

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 The male urethra is the conduit for semen during sexual intercourse. It
also serves as a passage for urine to flow. Urine typically contains epithelial
cells shed from the urinary tract. Urine cytology evaluates this urinary
sediment for the presence of cancerous cells from the lining of the urinary
tract, and it is a convenient noninvasive technique for follow-up analysis of
patients treated for urinary tract cancers. For this process, urine must be
collected in a reliable fashion, and if urine samples are inadequate, the urinary
tract can be assessed via instrumentation. In urine cytology, collected urine is
examined microscopically. One limitation is the inability to definitively
identify low-grade cancer cells and urine cytology is used mostly to identify
high-grade tumours.
E. Formation of Urine

The kidneys filter unwanted substances from the blood and produce urine to excrete
them. There are three main steps of urine formation: glomerular filtration, reabsorption,
and secretion. These processes ensure that only waste and excess water are removed from
the body.

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1) Filtration
Blood enters the afferent arteriole and flows into the glomerulus. Blood in the
glomerulus has both filterable blood components and non-filterable blood
components. Filterable blood components move toward the inside of the glomerulus
while non-filterable blood components bypass the filtration process by exiting
through the efferent arteriole. Filterable Blood components will then take a plasma
like form called glomerular filtrate. A few of the filterable blood components are
water, nitrogenous waste, nutrients and salts (ions). Nonfilterable blood components
include formed elements such as blood cells and platelets along with plasma proteins.
The glomerular filtrate is not the same consistency as urine, as much of it is
reabsorbed into the blood as the filtrate passes through the tubules of the nephron.
1) Reabsorption
Within the peritubular capillary network, molecules and ions are reabsorbed back into
the blood. Sodium Chloride reabsorbed into the system increases the osmolarity of
blood in comparison to the glomerular filtrate. This reabsorption process allows water
(H2O) to pass from the glomerular filtrate back into the circulatory system.
Glucose and various amino acids also are reabsorbed into the circulatory system.
These nutrients have carrier molecules that claim the glomerular molecule and release
it back into the circulatory system. If all of the carrier molecules are used up, excess
glucose or amino acids are set free into the urine. A complication of diabetes is the
inability of the body to reabsorb glucose. If too much glucose appears in the
glomerular filtrate it increases the osmolarity of the filtrate, causing water to be
released into the urine rather than reabsorbed by the circulatory system. Frequent
urination and unexplained thirst are warning signs of diabetes, due to water not being
reabsorbed.
Glomerular filtrate has now been separated into two forms: Reabsorbed Filtrate and
Non-reabsorbed Filtrate. Non-reabsorbed filtrate is now known as tubular fluid as it
passes through the collecting duct to be processed into urine.
2) Secretion
Some substances are removed from blood through the peritubular capillary network
into the distal convoluted tubule or collecting duct. These substances are Hydrogen

19
 ions, creatinine, and drugs. Urine is a collection of substances that have not been
reabsorbed during glomerular filtration or tubular reabsorbtion.
F. Disease and Disorder of Genitourinary System
Diseases of the kidneys or bladder can compromise urinary system functions. Below are
some common diseases of the urinary system.
1) Kidney Stones Form from Substances in Urine
The kidneys produce urine to eliminate waste. Kidney stones can form when mineral
and acid salts in the urine crystallize and stick together. If the stone is small, it can
pass easily through the urinary system and out of the body. A larger stone can get
stuck in the urinary tract, however. A stuck kidney stone causes pain and can block
the flow of urine.
2) Urinary Incontinence Is the Loss of Bladder Control
Most bladder control issues arise when the sphincter muscles of the urethra are too
weak or too active. If the sphincter muscles are too weak, a cough or sneeze can cause
urination. Sphincter muscles that are too active can trigger a sudden, strong urge to
urinate with little urine in the bladder. These issues are diagnosed as urinary
incontinence (UI). Women experience UI twice as often as men. It becomes more
common with age.
3) Fluid-filled Cysts Can Develop in the Kidneys
A simple kidney cyst is a rounded pouch or a closed pocket that is usually filled with
fluid. In polycystic kidney disease (PKD), clusters of cysts form inside the kidneys
and take the place of the normal tissue. The affected kidneys become enlarged and
work poorly. PKD is an inherited condition that often leads to kidney failure,
requiring dialysis or kidney transplantation. Acquired cystic kidney disease (ACKD)
typically affects people already on dialysis from chronic kidney disease. In ACKD
the kidneys do not enlarge and no other symptoms occur.
4) Chronic Kidney Disease Can Lead to Kidney Failure
In chronic kidney disease (CKD), the kidneys are damaged and unable to filter blood
properly. This damage can lead to a build-up of waste substances in the body and to
other problems, including kidney failure. The most common causes of CKD include

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diabetes, heart disease, and high blood pressure. A diseased kidney may look smaller
and have a granular surface.

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 CHAPTER III
CLOSING
A. Conclusion
The urinary system, also known as the renal system or urinary tract, consists of
the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to
eliminate waste from the body, regulate blood volume and blood pressure, control levels
of electrolytes and metabolites, and regulate blood pH. The urinary tract is the body's
drainage system for the eventual removal of urine.

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 BIBLYOGRAPHY
Dugdale, David (16 September 2011). "Female urinary tract". MedLine Plus Medical
Encyclopedia.
Caldwell HK, Young WS III, Lajtha A, Lim R (2006). "Oxytocin and Vasopressin:
Genetics and Behavioral Implications" (PDF). Handbook of Neurochemistry and
Molecular Neurobiology: Neuroactive Proteins and Peptides (3rd ed.). Berlin: Springer.
pp. 573–607.
"The Urinary Tract & How It Works | NIDDK". National Institute of Diabetes and
Digestive and Kidney Diseases.

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