Urinary Pathophysiology Terms and Objectives!
1. Kegel exercises: Repetitive isometric tightening and relaxing of the pubococcygeal
muscles which strengthens the pelvic fascia (pg. 814)."Kegel exercise, also known as
pelvic floor exercise, consists of repeatedly contracting and relaxing the muscles.!
2. Urethropexy: Surgical fixation to nearby tissue of a displaced"urethra"that is causing
incontinence by placing stress on the opening from the bladder."A"urethropexy"is a
surgical procedure where support is provided to the urethra."!
3. Post void cystometry: A cystometric test uses a catheter and manometer to
evaluate bladder urine volume and pressure in relation to involuntary bladder
contraction (the leak point pressure) and the urge to void (pg.751). Measure of bladder
pressure determined using a pressure-measuring catheter. Fluid volume and pressures
are measured as bladder is filled with fluid. Simultaneously pressures may be
measured in the rectum and sensations of bladder fullness is also recorded. Coughing
or straining can lead to involuntary bladder contractions. Male bladder holds 350-750
ml and female bladders hold 350-550 ml (pg. 744)."Although catheters are used, you
want to make sure the person really needs a catheter because they easier introduce
infection and you want to minimize the infection risk. If a person gets a cauti, hospital
acquired urinary tract infection, it is the nurses fault and the hospital has to pay.
Bladder scanners are used more often to check post void residual because they don’t
require and order and don’t have a risk of infection."!
4. Urge incontinence: Most common in older adults. It is the involuntary loss of urine
associated with abrupt and strong desire to void (urgency); often associated with
,involuntary contractions of detrusor. When associated with neurologic disorder, this is
called detrusor hyperreflexia. When no neurologic disorder exists, this is called
detrusor instability. Urge incontinence may be associated with decreased bladder wall
compliance (pg. 750). It is also incontinence in children with urgency (pg. 776)."!
5. Bladder overflow: Also overflow incontinence. Involuntary loss of urine with
distention of bladder. Associated with neurologic lesions below S1, polyneuropathies,
and urethral obstruction (i.e. enlarged prostate). If you find yourself leaking urine during
the day or even wetting the bed at night, you may be experiencing symptoms of
overflow incontinence. Overflow incontinence occurs when you are unable to
completely empty your bladder.!
6. Post void residual volume: Urine can be removed with catheter and measured or
ultrasound imagining can be used to measure urine. Postvoid residual of more than
200 ml is abnormal and requires further evaluation (pg.744). What is left when the
bladder does not fully empty (lecture notes).!
7. Underactive bladder (acute urinary retention): Underactive Bladder Syndrome"is a
chronic, complex and debilitating disease which affects the urinary bladder with
serious consequences. Patients with an underactive bladder can hold unusually large
amounts of urine but has a diminished sense of when the bladder is full and is not able
to contract the muscles sufficiently and as forcefully as it should, resulting in
incomplete bladder emptying."!
8. Overactive bladder (urge incontinence): Most common in older adults. It is the
involuntary loss of urine associated with abrupt and strong desire to void (urgency);
often associated with involuntary contractions of detrusor. When associated with
, neurologic disorder, this is called detrusor hyperreflexia. When no neurologic disorder
exists, this is called detrusor instability. Urge incontinence may be associated with
decreased bladder wall compliance (pg. 750).!
9. Acute cystitis: The inflammation of the bladder and is the most common site of UTI.
The morphologic appearance of the bladder through cystoscopy describes different
types of cystitis. With mild inflammation the mucosa is hyperemic (red). More advanced
cases may show diffuse hemorrhage termed hemorrhagic cystitis. Pus formation or
suppurative exudates on the epithelial surface of the bladder is termed suppurative
cystitis. Prolonged infection may lead to sloughing of the bladder mucosa with ulcer
formation termed ulcerative cystitis. The most severe infections may cause necrosis of
the bladder wall termed gangrenous cystitis (pg. 753). Necrosis of the bladder is when
the bladder wall is black or gray and is gone so the person can’t hold urine. This is
common in spinal cord patients. This may result in a urostomy to rid the bladder of
urine. Years of urinary tract infections can lead to bladder cancer. The most common
infecting microorganisms are uropathic strains of"Escherichia coli"and the second most
common is"Straphylococcus saprophyticus"(pg.753).!
10. Acute glomerulonephritis: Acute glomerulonephritis is inflammation of the
glomerulus caused by primary glomerular injury (ischemia, free radicals, drugs, toxins,
vascular disorders, and infection. Secondary glomerular injury is a consequence of
systemic diseases (DM, HTN, bacterial toxins, congestive heart failure).!
11. Anuria: Failure of the kidneys to produce urine (urine output less than 50 ml/day).
Anuria"is uncommon in acute tubular necrosis (ATN), involves both kidneys, and
1. Kegel exercises: Repetitive isometric tightening and relaxing of the pubococcygeal
muscles which strengthens the pelvic fascia (pg. 814)."Kegel exercise, also known as
pelvic floor exercise, consists of repeatedly contracting and relaxing the muscles.!
2. Urethropexy: Surgical fixation to nearby tissue of a displaced"urethra"that is causing
incontinence by placing stress on the opening from the bladder."A"urethropexy"is a
surgical procedure where support is provided to the urethra."!
3. Post void cystometry: A cystometric test uses a catheter and manometer to
evaluate bladder urine volume and pressure in relation to involuntary bladder
contraction (the leak point pressure) and the urge to void (pg.751). Measure of bladder
pressure determined using a pressure-measuring catheter. Fluid volume and pressures
are measured as bladder is filled with fluid. Simultaneously pressures may be
measured in the rectum and sensations of bladder fullness is also recorded. Coughing
or straining can lead to involuntary bladder contractions. Male bladder holds 350-750
ml and female bladders hold 350-550 ml (pg. 744)."Although catheters are used, you
want to make sure the person really needs a catheter because they easier introduce
infection and you want to minimize the infection risk. If a person gets a cauti, hospital
acquired urinary tract infection, it is the nurses fault and the hospital has to pay.
Bladder scanners are used more often to check post void residual because they don’t
require and order and don’t have a risk of infection."!
4. Urge incontinence: Most common in older adults. It is the involuntary loss of urine
associated with abrupt and strong desire to void (urgency); often associated with
,involuntary contractions of detrusor. When associated with neurologic disorder, this is
called detrusor hyperreflexia. When no neurologic disorder exists, this is called
detrusor instability. Urge incontinence may be associated with decreased bladder wall
compliance (pg. 750). It is also incontinence in children with urgency (pg. 776)."!
5. Bladder overflow: Also overflow incontinence. Involuntary loss of urine with
distention of bladder. Associated with neurologic lesions below S1, polyneuropathies,
and urethral obstruction (i.e. enlarged prostate). If you find yourself leaking urine during
the day or even wetting the bed at night, you may be experiencing symptoms of
overflow incontinence. Overflow incontinence occurs when you are unable to
completely empty your bladder.!
6. Post void residual volume: Urine can be removed with catheter and measured or
ultrasound imagining can be used to measure urine. Postvoid residual of more than
200 ml is abnormal and requires further evaluation (pg.744). What is left when the
bladder does not fully empty (lecture notes).!
7. Underactive bladder (acute urinary retention): Underactive Bladder Syndrome"is a
chronic, complex and debilitating disease which affects the urinary bladder with
serious consequences. Patients with an underactive bladder can hold unusually large
amounts of urine but has a diminished sense of when the bladder is full and is not able
to contract the muscles sufficiently and as forcefully as it should, resulting in
incomplete bladder emptying."!
8. Overactive bladder (urge incontinence): Most common in older adults. It is the
involuntary loss of urine associated with abrupt and strong desire to void (urgency);
often associated with involuntary contractions of detrusor. When associated with
, neurologic disorder, this is called detrusor hyperreflexia. When no neurologic disorder
exists, this is called detrusor instability. Urge incontinence may be associated with
decreased bladder wall compliance (pg. 750).!
9. Acute cystitis: The inflammation of the bladder and is the most common site of UTI.
The morphologic appearance of the bladder through cystoscopy describes different
types of cystitis. With mild inflammation the mucosa is hyperemic (red). More advanced
cases may show diffuse hemorrhage termed hemorrhagic cystitis. Pus formation or
suppurative exudates on the epithelial surface of the bladder is termed suppurative
cystitis. Prolonged infection may lead to sloughing of the bladder mucosa with ulcer
formation termed ulcerative cystitis. The most severe infections may cause necrosis of
the bladder wall termed gangrenous cystitis (pg. 753). Necrosis of the bladder is when
the bladder wall is black or gray and is gone so the person can’t hold urine. This is
common in spinal cord patients. This may result in a urostomy to rid the bladder of
urine. Years of urinary tract infections can lead to bladder cancer. The most common
infecting microorganisms are uropathic strains of"Escherichia coli"and the second most
common is"Straphylococcus saprophyticus"(pg.753).!
10. Acute glomerulonephritis: Acute glomerulonephritis is inflammation of the
glomerulus caused by primary glomerular injury (ischemia, free radicals, drugs, toxins,
vascular disorders, and infection. Secondary glomerular injury is a consequence of
systemic diseases (DM, HTN, bacterial toxins, congestive heart failure).!
11. Anuria: Failure of the kidneys to produce urine (urine output less than 50 ml/day).
Anuria"is uncommon in acute tubular necrosis (ATN), involves both kidneys, and
