Diagnosis of Medical Problems of the Urinary System

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  • 0:00 Diagnosing the Urinary System
  • 0:34 Imaging Diagnostic Test
  • 3:50 Physical and Chemical…
  • 5:08 Lesson Summary
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Lesson Transcript
Instructor: Adrianne Baron

Adrianne has a master's degree in cancer biology and has taught high school and college biology.

This lesson is going to cover the diagnostic testing that is used to detect problems in the urinary tract. We will look at imaging as well as physical and chemical tests.

Diagnosing the Urinary System

Eric is leaving the gym and talking to his workout buddy about some problems he has noticed. He is having some issues with urinating and isn't quite sure what is wrong. His buddy suggests that he make an appointment to see his doctor to have some tests done so the doctor can determine what is going on and fix it.

A week later, Eric walks into the office where you just started working as a medical assistant. You notice his lists of complaints and try to decide which tests the doctor will likely order. You begin mentally going through the different options.

Imaging Diagnostic Tests

You recall some things that you learned in your training and realize that the doctor will probably want to start off with imaging tests to get a visual on the different parts of the urinary tract.

The first test to pop in your mind is the KUB, which is an x-ray of the kidneys, ureters, and bladder. The KUB can help the doctor see obstructions like stones and growths, or abnormalities like holes or weakened areas in the kidneys, ureters, and bladder.

Another imaging test is the bladder ultrasound, which sends sound waves through the bladder to produce an image of the bladder. This ultrasound will be performed on Eric before and after he urinates. From the ultrasound, the doctor can tell things like if the bladder empties properly, stones are present, and if the bladder is inflamed. Another thing that can be determined during a bladder ultrasound is if Eric's prostate gland is enlarged and causing the bladder to shift out of place or itself becomes enlarged.

Or perhaps Eric will undergo a procedure called catheterization cystography, in which x-rays of the bladder and urethra are taken after contrast medium is injected through a catheter. The catheter is inserted and a contrast medium is injected through the urethra into the bladder to make the picture better. This procedure can help to find structural problems that may be causing urinary incontinence and consistent UTIs.

The doctor could also perform a cystoscopy, which is when a scope is inserted into the urethra to view the bladder. This can help to detect any structural abnormalities in the bladder or causes for bleeding. Obstructions in the bladder can also be seen by cystoscopy. During a cystoscopy, the doctor may decide to also do a retrograde urography, where a catheter is extended from the scope to inject dye into the ureters and kidneys and x-ray images are taken. This is normally only done if other x-rays haven't led to a definitive diagnosis for the cause of recurring cancer or bloody urine.

A voiding cystourethrography may be ordered to check for any problems that could be caused by Eric's prostate gland being enlarged. This test is also used in women to check the position of the bladder and in children to detect possible reasons for urine flowing backwards in the urinary tract. A voiding cystourethrography is when contrast dye is injected into the bladder through a catheter and multiple X-rays from different angles are taken when the bladder is full and again when the patient is urinating.

Another set of X-rays taken of the urinary tract after contrast medium is injected into a vein is called intravenous pyelogram. These images can help the doctor tell what abnormalities exist that could be causing urine to be retained or flow backwards in the urinary tract.

And the final possible x-ray image uses computers to get a 3-dimensional view of the structures of the urinary tract by doing a computer tomography scan. This can help to determine if there are any stones in the tract or other obstructions, as well as detect tumors, injuries, and infections.

Physical and Chemical Diagnostic Testing

But imaging is not, of course, the only way that the doctor can help diagnose what's wrong with Eric.

One standard test that you are very sure will be performed on Eric is a urinalysis, which is a visual, chemical, and microscopic examination of urine. This test is done to detect any infections or conditions, such as diabetes, as well as abnormalities in urine composition. A urinalysis gives the doctor a lot of information and can help to narrow down which other tests are needed and possible causes for Eric's problems.

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