Human urinary system

The human urinary system is a set of organs responsible for the production, storage and expulsion
of urine. Through the urine the nitrogenous wastes of metabolism (urea, creatinine, uric acid) and
other toxic substances are eliminated from the organism. The human urinary system consists of 2
kidneys and a set of urinary tract. The kidney produces urine and is responsible for the
osmoregulation process. The urine formed in the kidneys is transported by the ureters to the
urinary bladder where it is stored until it exits through the urethra during the process of urination.
The basic unit of filtration is called nephron, each kidney has about 1 000 000 nephrons.1

Urine formation
Urine is formed basically through three processes that develop in the nephrons. The three basic
processes of urine formation are:

 Filtration. It allows the passage of liquid from the glomerulus to the Bowman's capsule.
The fluid that enters the glomerulus has a chemical composition similar to the blood
plasma, but without proteins, which do not manage to cross the glomerular capillaries.
The cellular portion of the blood, that is, the red blood cells, the white blood cells and the
platelets, also do not cross the glomeruli and do not form part of the filtered liquid.
Through the index of glomerular filtration, it is possible to infer that every 24 hours they
are filtered, in both kid
  Resorption. Many of the components of the plasma that are filtered in the glomerulus,
return back to the blood. It is the process by which substances pass from the inside of the
renal tubule to the per tubular capillaries, that is, to the blood. This process allows the
recovery of water, salts, sugars and amino acids that were filtered in the glomerulus.
 Secretion. It is the opposite of reabsorption; at this stage some blood components are
eliminated by active secretion of the cells of the renal tubules. Secretion is not
synonymous with excretion, in the secretion substances are actively removed in the light of
the tubule. By means of a secretion mechanism, for example hydrogen ions H + are
eliminated, which contributes to maintain the blood pH at suitable levels. It is also
eliminated by ammonium (NH4 +) secretion and some drugs.5

During passage through the renal tubule system, the primary urine loses about 99% of the initial
volume, mainly by water absorption, so the final urine contains the waste substances such as urea
and creatinine at a much higher concentration than the initial.6 In this way the kidney is a very
effective system in the elimination of waste substances, the concentration of creatinine in blood,
for example, ranges between 0.7 and 1.3 mg per dl, while in the final urine is between 100 and 160
mg per dl, 130 times higher.

Organs of the urinary system

Kidney

The kidney is covered by a capsule of dense connective tissue called the renal capsule, on its
medial border there is an incision called the renal hilum where you can see the entrance of the
renal artery and the exit of the renal vein and the ureter.

Si se corta el riñón paralelamente a sus dos caras, se puede observar que está compuesto por dos
zonas de color distinto, a las que se ha llamado medular o interna, y cortical o externa. En la zona
medular son visibles unas estriaciones de forma piramidal que se llaman pirámides de Malpighi (o
renales) que presentan un vértice orientado hacia los cálices (papilas).

 Cortex or cortex: It is located on the outside and is light red. It presents in its outer part
small red dots that correspond to the corpúsculos of Malpighi. The cortical substance
covers the medullar and also fills the spaces left by the Malpighi pyramids.

Medullary area: It occupies the inner part and is dark red. It is composed of between 8
and 18 triangular formations that are called the Malpighian kidney pyramids. Its base is in
contact with the cortical substance and its apex, which has 15 to 20 small holes, is in
communication with a renal calyx, which carries urine to the renal pelvis.
Ureter

The ureters are two tubes or tubes about 21 to 30 cm long, and between 3 and 4 millimeters in
diameter, although their width is not uniform and have several narrowings. They transport urine
from the renal pelvis to the bladder, at the base of which they form the ureteral meatus, which has
a valve structure that allows the urine to pass drop by drop from the ureter to the bladder, but not
in the opposite direction. The wall of the ureter is formed by several layers, one of them contains
smooth muscle that when contracted causes ureteral peristalsis that facilitates the advance of the
urine.7

Urinary bladder

The urinary bladder is a hollow organ located in the lower part of the abdomen and superior of the
pelvis, destined to contain the urine that comes from the kidneys through the ureters. The bladder
is a bag made up of muscles that is responsible for storing urine and releasing it. When it is empty,
its upper and lower walls come into contact, taking an ovoid shape when it is full. Its capacity is
about 300 to 450 ml. Its interior is lined with a mucosa with a polyester-lined epithelium
impermeable to urine. Its wall contains a smooth muscle called the detrusor muscle, which by
contracting and with the help of the contraction of the abdominal muscles, produces the
evacuation of urine through the urethra. This is called urination. The part of the bladder that
communicates with the urethra is provided with a circular or sphincter muscle that prevents the
involuntary exit of the urine. At the base of the bladder, the urethra is opened, a conduit that
carries urine to the outside during urination.

Urethra

The urethra is the tube that carries urine from the urinary bladder to the outside. It is markedly
different between the two sexes. The male urethra is about 20 cm long, has double function, it
serves for the expulsion of semen and urine, it is divided into several segments: prostatic urethra,
membranous urethra, bulbar urethra and penile urethra. This last portion passes through the penis
surrounded by the corpora cavernosos and spongy, leading to the outside in the urethral meatus.
The female urethra is shorter than the male, measuring between 3 and 4 cm long and ending at
the vulva, in front of the vaginal orifice, its
function is only urinary.7
Urination

Urination is the act of emptying the urinary bladder and the expulsion of urine to the outside
through the urethra. The urinary bladder dilates progressively as it fills with urine, by distension of
its muscle fibers. When the stretch is maximum there is a need to empty the bladder, for which the
stimulation of nerve fibers from the parasympathetic nervous system causes the detrusor muscle
contraction and the relaxation of the external urethral sphincter. This process is automatic, the
product of a spinal reflex, although it is controlled by higher brain centers that can inhibit the reflex
or facilitate it, so that the act becomes voluntary.8

The frequency of urination varies from one individual to another because it involves personal
factors such as habit, the psychic state of joy or tension, water consumption and sweating. The
amount of urine emitted in 24 hours is on average 1500 cm³. The urinary bladder has great
distension capacity, in case of retention due to obstruction, more than one liter of urine can
accumulate inside it; on the other hand, if there is cystitis, there may be a desire to urinate when
the bladder contains only 50 ml.
Diseases of the urinary system

There are different diseases that can affect the urinary system, some of
the most common are listed below.

Urethritis. It consists of inflammation of the walls of the urethra due to a bacterial infection or to
irritative substances such as soaps and detergents. It causes discomfort or pain when urinating
(dysuria) and urethral discharge.9

Cystitis. It is the acute or chronic inflammation of the urinary bladder. It can have different causes,
the most frequent is an infection by gram negative bacteria. The most common symptoms are:
increased frequency of urination, presence of turbidity of the urine and burning sensation when
urinating (dysuria).

Pyelonephritis It is a high urinary tract infection that affects the kidney.

Renal insufficiency. It is defined as the decrease in glomerular filtration. If it appears abruptly it is

called acute renal failure, otherwise it is called chronic renal failure. The causes can be very varied,
one of the most frequent is the deterioration of renal function caused by diabetes mellitus
(diabetic nephropathy).

Renal colic. It is an intense pain in the area of the kidneys and genital organs that sometimes is
accompanied by blood loss in the urine. It is due to kidney stones formed by precipitates of
different salts such as phosphates, urates and oxalates that obstruct the urinary tract and impede
the normal flow of urine.

Renal calculus. It is a piece of solid material that is formed inside the kidney from substances that
are in the urine. The kidney stone, sometimes called a stone, can stay in the kidney or go down
through the urinary tract. The intensity of the symptomatology that it provokes is generally related
to the size of the calculus. Sometimes expulsion occurs with almost no symptoms