Obstetrics and Gynecology
The Genitourinary system consists of the urinary tract and reproductive organs. Diseases that affect this system are a variety of conditions that can affect people of all ages. Urologic diseases affect specific organs in males and in females – the urinary tract in females and urinary tract or reproductive organs in males (O'Connell, 2016).
Some of the most common diseases include Urinary Tract Infections (UTI), Urinary Incontinence and Benign Prostatic Hyperplasia (BPH). UTI basically occurs when bacteria invades the urinary system and infects any part of the system although the bladder and urethra are the most commonly affected parts. Women compared men have higher chances for UTI because of the shorter urethras and the proximity of the anus to the urethra (WebMD, 2016). Symptoms include dysuria or pain in urination and urinary frequency and urgency. Urinary Incontinence is urinary control loss due to weakening of urethral sphincter or overactivity of the detrusor muscles of the bladder (Nhs.uk, 2014). The most common types of incontinence are stress incontinence and urge incontinence. When urine leaks out when one coughs or lifts a heavy object, this is stress incontinence. An intense urge to pass urine even when the bladder is not full is urge incontinence. Lastly, BPH is a non-malignant enlargement of the prostate usually with lower urinary tract symptoms (LUTS) that occurs as men age. LUTS consist of urinary urgency, nocturia, frequency and hesitancy. Aging, late activation of cell growth, genetics and changes in hormones are some of the possible causes of BPH (Dhingra & Bhagwat, 2011).
Shock Wave Lithotripsy (SWL) or Extracorporeal Shock Wave Lithotripsy (ESWL) is a nonsurgical procedure that crushes kidney stones using high energy shockwaves from outside the body until stone fragments are minute enough to pass in urine (The National Kidney Foundation, 2009).
Kidney Biopsy or renal biopsy is done by extracting a small piece of kidney by inserting a needle through the skin. The specimen is examined under a microscope to diagnose or monitor a kidney problem (MayoClinic.org, 2015).
Transurethral Resection of the Prostate is a surgical procedure to remove a section of the prostate to relieve the symptoms of an enlarged prostate. An instrument is inserted through the urethra and no incision is made. Post-operatively, the patient undergoes cystoclysis or bladder irrigation to remove urine, blood and blood clots (WebMD, 2015).
Intravenous Pyelogram , also called excretory urogram is an imaging test that uses an X-ray dye to view the kidneys, bladder and ureters (tubes from kidneys to the bladder). This procedure is done to diagnose disorders including kidney and bladder stones, tumors and enlarged prostate. An iodine contrast solution is introduced through a vein and viewed through X-ray (Mayoclinic.org, 2015). Kidney, Ureter, and Bladder X-ray or KUB is done to diagnose the causes for pain in the abdomen and view the urinary system in general. Urinalysis (UA) consists of tests to examine the appearance, concentration (urine specific gravity) detect and measure components that are in the urine sample. UA is part of routine lab tests that points to specific diseases such as UTI or kidney disease (Mayoclinic.org, 2015).
Pelvic inflammatory Disease is inflammation of the female reproductive organs most commonly a result of STI. This occurs mostly in young and sexually active women. Usually, PID has no obvious symptoms but if symptoms are present, fever, pain in the pelvic region, abnormal vaginal discharge, menorrhagia or abnormally prolonged or heavy menstrual periods, dyspareunia (painful sexual intercourse) and fatigue may manifest (Aviva.co.uk, 2010). Endometriosis affects 1 in 5 women of childbearing age. The endometrial tissue is abnormally attached to the organs in the pelvic cavity and can lead to bleeding, pain and ultimately, scarring (Aviva.co.uk, 2010). Bacterial Vaginosis is a condition more common in sexually active women wherein there is an abnormal growth of normal bacteria in the vagina. PID may result from this condition (Aviva.co.uk, 2010).
Myomectomy is a procedure in which uterine fibroids also called leiomyomas are removed surgically. These uterine fibroids are usually benign. Hysterectomy is the removal of the uterus. This procedure is commonly done to remove uterine fibroids. Other reasons for performing this surgery are abnormal vaginal bleeding, cervical dysplasia which is precancerous alteration in the cervix, endometriosis, uterine cancer. Oophorectomy is the surgical removal of one or both the ovaries. Removal of one ovary is called unilateral oophorectomy while the removal of both is called bilateral oophorectomy. This procedure is performed for a number of reasons like ovarian cancer, endometriosis, benign tumors, and abscess. Often, oophorectomy is done in combination with other surgical procedures such as hysterectomy and salpingectomy or removal of fallopian tubes (Mayoclinic.org, 2014).
Colposcopy is usually an outpatient procedure done by a specialist called colposcopist. This is done to view the vulva, vagina and cervix. A biopsy or small sample of tissue is extracted if abnormality is detected in the organs. Using a lighted magnifying device called a colposcope, the colposcopist can view the specific organs and check for problems. An abnormal Pap smear result usually initiates colposcopy to be done (WebMD, 2014). Pap smear or Papanikolaou test is a screening test for cervical cancer recommended for women aged 18 to 70 who are or have been sexually active. Cells from the cervix are scraped using a speculum and to the laboratory for further examination. The test does not detect HPV (human papillomavirus) but it detects the cellular abnormalities caused by the HPV (Kelbach, 2015). Hysterosalpingogram is an imaging procedure of the internal structure of the uterus, fallopian tubes and surrounding areas. This procedure aids in diagnosing abnormal structures of the uterus or fallopian tube. A tube is inserted transvaginally and the contrast medium or dye is put through the tube from the vagina to the uterus and flow into the fallopian tubes. Fluoroscopy using a steady beam of X-ray is used to take images of the dye passing through the uterus and fallopian tubes (WebMD, 2014).
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