Disorders of the Urinary System

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Urologists are physicians who specialize in treating urinary system disorders. One of the most serious disorders urologists treat is renal failure, which slows or stops the filtration of blood, causing toxic waste products to build up in the blood. Acute renal failure, which occurs suddenly, may be caused by bacterial infection, injury, shock, congestive heart failure, drug poisoning, or severe bleeding following surgery. Treatment may include drugs to address the underlying cause or to stimulate proper kidney function, blood transfusions, surgery, or, in some cases, kidney dialysis, in which the blood is mechanically filtered.

Chronic renal failure is a progressive deterioration of kidney function over a long period of time. It can be caused by diseases such as hypertension, diabetes, lupus erythematosus, acquired immunodeficiency syndrome (AIDS), and a form of cancer called myeloma. If diagnosed early the degenerative process can be slowed, but not reversed, by interventions that can range from simply restricting fluid intake and protein consumption (proteins are the main source of waste products) to taking drugs to address the underlying disease that is damaging the kidneys. Some patients may go on to develop end-stage renal failure, a life-threatening condition that requires long-term dialysis or a kidney transplant.

Urinary calculi, commonly known as kidney stones, result from the gradual buildup of crystallized salts and minerals in the urine. Kidney stones can cause intense pain if they obstruct a passageway that carries urine. Usually, the stones pass through and out of the urinary tract on their own. If they fail to pass out of the body, they can be removed surgically or broken up nonsurgically by an ultrasound technique called lithotripsy.

Bacterial infections, most frequently caused by the common intestinal bacterium Escherichia coli, can occur in any part of the urinary system. Antibiotics usually conquer the infection, although recurrent and chronic infections are not uncommon.

Among the many inherited and congenital disorders of the urinary system are polycystic renal diseases, in which numerous cysts form in the kidney, reducing the amount of functioning renal tissue. Kidney dialysis or transplantation usually is necessary to avoid kidney failure and death. Hypospadias is a birth defect in which the male urinary opening is misplaced on the penis; it may be under the head of the penis or as far away as the scrotum. Surgery before the child reaches 24 months can correct the defect, permitting normal urination and, later, sexual intercourse.

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