(urino-, uro-) combining form denoting urine or the urinary system.
The daily urine output varies, but averages around 1,500 ml in adults, less in children. The ?uid intake and ?uid output (urine and PERSPIRATION) are interdependent, so as to maintain a relatively constant ?uid balance. Urine output is increased in certain diseases, notably DIABETES MELLITUS; it is diminished (or even temporarily stopped) in acute glomerulonephritis (see under KIDNEYS, DISEASES OF), heart failure, and fevers generally. Failure of the kidneys to secrete any urine is known as anuria, while stoppage due to obstruction of the ureters (see URETER) by stones, or of the URETHRA by a stricture, despite normal urinary secretion, is known as urinary retention.
Normal urine is described as straw- to amber-coloured, but may be changed by various diseases or drugs. Chronic glomerulonephritis or poorly controlled diabetes may lead to a watery appearance, as may drinking large amounts of water. Consumption of beetroot or rhubarb may lead to an orange or red colour, while passage of blood in the urine (haematuria) results in a pink or bright red appearance, or a smoky tint if just small amounts are passed. A greenish urine is usually due to BILE, or may be produced by taking QUININE.
Healthy urine has a faint aroma, but gives o? an unpleasant ammoniacal smell when it begins to decompose, as may occur in urinary infections. Many foods and additives give urine a distinctive odour; garlic is particularly characteristic. The density or speci?c gravity of urine varies normally from 1,015 to 1,025: a low value suggests chronic glomerulonephritis, while a high value may occur in uncontrolled diabetes or during fevers. Urine is normally acidic, which has an important antiseptic action; it may at times become alkaline, however, and in vegetarians, owing to the large dietary consumption of alkaline salts, it is permanently alkaline.
Chemical or microscopical examination of the urine is necessary to reveal abnormal drugs, poisons, or micro-organisms. There are six substances which must be easily detectable for diagnostic purposes: these are ALBUMINS, blood, GLUCOSE, bile, ACETONE, and PUS and tube-casts (casts from the lining of the tubules in the kidneys). Easily used strip tests are available for all of these, except the last.
Excess of urine It is important to distinguish urinary frequency from increase in the total amount of urine passed. Frequency may be due to reduced bladder capacity, such as may be caused by an enlarged PROSTATE GLAND, or due to any irritation or infection of the kidneys or bladder, such as CYSTITIS or the formation of a stone. Increased total urinary output, on the other hand, is often a diagnostic feature of diabetes mellitus. Involuntary passage of urine at night may result, leading to bed wetting, or NOCTURNAL ENURESIS in children. Diagnosis of either condition, therefore, means that the urine should be tested for glucose, albumin, gravel (fragments of urinary calculi), and pus, with appropriate treatment.... urine
The bladder lies in the anterior half of the PELVIS, bordered in front by the pubis bone and laterally by the side wall of the pelvis. Superiorly the bladder is covered by the peritoneal lining of the abdomen. The bottom or base of the bladder lies against the PROSTATE GLAND in the male and the UTERUS and VAGINA in the female.... urinary bladder
Habitat: Throughout the plains of India from Punjab to Assam and Southward to Kerala up to 1,000 m.
Ayurvedic: Bhuumyaamataki (var.), Taamravalli.Siddha/Tamil: Senkeezhnelli.Folk: Laal-bhui-aamlaa, Hazaar- mani.Action: See P. amarus.
The leaf and stem gave flavonoids— quercetin, astragalin, quercitrin, iso- quercitrin and rutin; Me-brevifolin- carboxylate and tri-dehydrochebulic acid.... phyllanthus urinariaCauses Neurological injury, such as trauma to the spinal cord, may cause bladder weakness, leading to retention, although this is rare. Obstruction to out?ow is more common: this may be acute and temporary, for example after childbirth or following surgery for piles (HAEMORRHOIDS); or chronic, for example, with prostatic enlargement (see PROSTATE GLAND). Commonly seen in elderly men, this leads to reduced bladder capacity, with partial emptying every few hours. Total retention is rare, but may result from a stricture, or narrowing, of the URETHRA (see also URETHRA, DISEASES OF AND INJURY TO) – usually the result of infection or injury – or to pressure from a large neighbouring tumour.
Retention is generally treated by regular use of a urethral catether (see CATHETERS), various types of which are available. Tapping of the bladder with a needle passed above the pubis is rarely necessary, but may occasionally be required in cases of severe stricture.... urine retention
Cystitis Most cases of cystitis are caused by bacteria which have spread from the bowel, especially Escherichia coli, and entered the bladder via the urethra. Females are more prone to cystitis than are males, owing to their shorter urethra which allows easier entry for bacteria. Chronic or recurrent cystitis may result in infection spreading up the ureter to the kidney (see KIDNEY, DISEASES OF).
Symptoms Typically there is frequency and urgency of MICTURITION, with stinging and burning on passing urine (dysuria), which is often smelly or bloodstained. In severe infection patients develop fever and rigors, or loin pain. Before starting treatment a urine sample should be obtained for laboratory testing, including identi?cation of the invading bacteria.
Treatment This includes an increased ?uid intake, ANALGESICS, doses of potassium citrate to make the urine alkaline to discourage bacterial growth, and an appropriate course of ANTIBIOTICS once a urine sample has been ana-lysed in the laboratory to con?rm the diagnosis and determine what antibiotics the causative organism is likely to respond to.
Stone or calculus The usual reason for the formation of a bladder stone is an obstruction to the bladder out?ow, which results in stagnant residual urine – ideal conditions for the crystallisation of the chemicals that form stones – or from long-term indwelling CATHETERS which weaken the natural mechanical protection against bacterial entry and, by bruising the lining tissues, encourage infection.
Symptoms The classic symptom is a stoppage in the ?ow of urine during urination, associated with severe pain and the passage of blood.
Treatment This involves surgical removal of the stone either endoscopically (litholapaxy); by passing a cystoscope into the bladder via the urethra and breaking the stone; or by LITHOTRIPSY in which the stone (or stones) is destroyed by applying ultrasonic shock waves. If the stone cannot be destroyed by these methods, the bladder is opened and the stone removed (cystolithotomy).
Cancer Cancer of the bladder accounts for 7 per cent of all cancers in men and 2·5 per cent in women. The incidence increases with age, with smoking and with exposure to the industrial chemicals, beta-napththylamine and benzidine. In 2003, 2,884 men and 1,507 women died of bladder cancer in England and Wales.
Symptoms The classical presenting symptom of a bladder cancer is the painless passing of blood in the urine – haematuria. All patients with haematuria must be investigated with an X-ray of their kidneys, an INTRAVENOUS PYELOGRAM (UROGRAM) and a cystoscopy.
Treatment Super?cial bladder tumours on the lining of the bladder can be treated by local removal via the cystoscope using DIATHERMY (cystodiathermy). Invasive cancers into the bladder muscle are usually treated with RADIOTHERAPY, systemic CHEMOTHERAPY or surgical removal of the bladder (cystectomy). Local chemotherapy may be useful in some patients with multiple small tumours.... urinary bladder, diseases of
Causes may also be psychological: worry, excitement, emotional crises such as school exams. Where the trouble is persistent attention should be focussed on the bladder (cystitis), inflammation of the kidneys, even the presence of stone.
Simple frequency may arise from cold weather, nervous excitement, or early pregnancy. Other predisposing factors are: diabetes mellitis, enlarged prostate gland, stone in the kidney or bladder. Alternatives. Teas. American Cranesbill, Agrimony, Cornsilk, Horsetail, Passion flower, Plantain, Skullcap, Uva Ursi, Huang Qi (Chinese). Saw Palmetto (prostate gland).
Tablets/capsules. Cranesbill (American), Gentian, Liquorice.
Powders. Equal parts: Cranesbill, Horsetail, Liquorice. Mix. Dose: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.
Tinctures. Equal parts: Cramp bark and Horsetail. Dose: 30-60 drops, thrice daily.
Practitioner. Tinctures. Alternatives:–
Formula 1. Ephedra 30ml; Geranium 20ml; Rhus aromatica 20ml; Thuja 1ml. Aqua to 100ml. Sig: 5ml (3i) tds aq cal pc.
Formula 2. Equal parts: Ephedra and Horsetail. 15-60 drops thrice daily; last dose bedtime.
A. Barker FNIMH. Dec Jam Sarsae Co Conc BPC 1 fl oz (30ml) . . . Liquid extract Rhus 240 minims (16ml) . . . Liquid extract Passiflora 60 minims (4ml) . . . Syr Althaea 2 fl oz (60ml) . . . Aqua to 8oz (240ml). Dose: 2 teaspoons thrice daily; last dose bedtime.
Tincture Arnica. German traditional. 1 drop in honey at bedtime.
Pelvic exercises. Alternate hot and cold Sitz baths. Swimming, Cycling.
Address. Incontinence Advisory Service, Disabled Living Foundation, 380-384 Harrow Road, London W9 2HU. ... frequency of urine
Causes include psychiatric problems, which may cause a person to drink compulsively; diabetes mellitus; disorders of the kidney known as salt-losing states; and central diabetes insipidus. Any person who passes large quantities of urine should consult a doctor.... urination, excessive
Most urinary tract stones are composed of calcium oxalate or other salts crystallized from the urine. These may be associated with a diet rich in oxalic acid (found in leafy vegetables and coffee); high levels of calcium in the blood as a result of hyperparathyroidism; or chronic dehydration. Other types of stone are associated with gout and some cancers. An infective stone is usually a result of chronic urinary tract infection.
In developing countries, bladder stones usually occur as a result of dietary deficiencies. In developed countries, they are usually caused by an obstruction to urine flow from the bladder and/or a longstanding urinary tract infection.
The most common symptom of a stone in the kidney or ureter is renal colic (a severe pain in the loin) that may cause nausea and vomiting. There may be haematuria (blood in the urine). A bladder stone is usually indicated by difficulty in passing urine. The site of the stone can usually be confirmed by intravenous or retrograde urography.
Renal colic is treated with bed rest and an opioid analgesic (painkiller).
With an adequate fluid intake, small stones are usually passed in the urine without problems.
The first line of treatment for larger stones is lithotripsy, which uses ultrasonic or shock waves to disintegrate the stones.
Alternatively, cytoscopy can be used to crush and remove stones in the bladder and lower ureter.
In some cases, surgery may be needed.... calculus, urinary tract
If weak pelvic muscles are causing stress incontinence, pelvic floor exercises may help. Sometimes, surgery may be needed to tighten the pelvic muscles or correct a prolapse. Anticholinergic drugs may be used to relax the bladder muscle if irritable bladder is the cause.
If normal bladder function cannot be restored, incontinence pants can be worn; men can wear a penile sheath leading into a tube connected to a urine bag. Some people can avoid incontinence by self-catheterization (see catheterization, urinary). Permanent catheterization is necessary in some cases.... incontinence, urinary
Complete retention causes discomfort and lower abdominal pain, except when nerve pathways are defective. The full bladder can be felt above the pubic bone. However, chronic or partial retention may not cause any serious symptoms. Retention can lead to kidney damage and, often, a urinary tract infection.Treatment of retention is by catheterization (see catheterization, urinary).
The cause is then investigated.
Obstruction can usually be treated; if nerve damage is the cause, permanent or intermittent catheterization is sometimes necessary.... urinary retention
In both sexes, causes of urinary tract infections include stones (see calculus, urinary tract), bladder tumours, congenital abnormalities of the urinary tract, or defective bladder emptying as a result of spina bifida or a spinal injury. The risks of developing a urinary tract infection can be reduced by strict personal hygiene, drinking lots of fluids, and regularly emptying the bladder.
Urethritis can lead to the formation of a urethral stricture. Cystitis usually only causes complications if the infection spreads to the kidneys. Pyelonephritis, if it is left untreated, can lead to permanent kidney damage, septicaemia, and septic shock.
The infection is diagnosed by the examination of a urine culture. Further investigations using urography or ultrasound scanning may be necessary. Most infections of the urinary tract are treated with antibiotic drugs.... urinary tract infection
The most common cause, especially in women, is cystitis. Other causes include a bladder tumour, bladder stone (see calculus, urinary tract), urethritis, balanitis, prostatitis, vaginal candidiasis (thrush), or allergy to vaginal deodorants. Strangury is usually caused by spasm of an inflamed bladder wall, but it may be due to bladder stones. Mild discomfort when passing urine may be caused by highly concentrated urine.
Dysuria may be investigated by physical examination, urinalysis, urography, or cystoscopy. (See also urethral syndrome, acute.)... urination, painful
Conditions of abnormal production of urine include excessive production (see urination, excessive), oliguria, and anuria. Abnormal appearances of urine include cloudiness (which may be caused by a urinary tract infection, a calculus, or the presence of salts); haematuria; discoloration from certain foods or drugs; and frothiness (which may be caused by an excess of protein).
Amenorrhoea/lack of menstruation (M,B):
French basil, carrot seed, celery seed, cinnamon leaf, dill, sweet fennel, hops, hyssop, juniper, laurel, lovage, sweet marjoram, myrrh, parsley, rose (cabbage & damask), sage (clary & Spanish), tarragon, yarrow.
Dysmenorrhoea/cramp, painful or difficult menstruation (M,C,B):
Melissa, French basil, carrot seed, chamomile (German & Roman), cypress, frankincense, hops, jasmine, juniper, lavandin, lavender (spike & true), lovage, sweet marjoram, rose (cabbage & damask), rosemary, sage (clary & Spanish), tarragon, yarrow.
Cystitis (C,B,D):
Canadian balsam, copaiba balsam, bergamot, cedarwood (Atlas, Texas & Virginian), celery seed, chamomile (German & Roman), cubebs, eucalyptus blue gum, frankincense, juniper, lavandin, lavender (spike & true), lovage, mastic, niaouli, parsley, Scotch pine, sandalwood, tea tree, thyme, turpentine, yarrow.
Frigidity (M,S,B,V):
Cassie, cinnamon leaf, jasmine, neroli, nutmeg, parsley, patchouli, black pepper, cabbage rose, rosewood, clary sage, sandalwood, ylang ylang.
Lack of nursing milk (M):
Celery seed, dill, sweet fennel, hops.
Labour pain & childbirth aid (M,C,B):
Cinnamon leaf, jasmine, true lavender, nutmeg, parsley, rose (cabbage & damask), clary sage.
Leucorrhoea/white discharge from the vagina (B,D):
Bergamot, cedarwood (Atlas, Texas & Virginian), cinnamon leaf, cubebs, eucalyptus blue gum, frankincense, hyssop, lavandin, lavender (spike & true), sweet marjoram, mastic, myrrh, rosemary, clary sage, sandalwood, tea tree, turpentine.
Menopausal problems (M,B,V):
Cypress, sweet fennel, geranium, jasmine, rose (cabbage & damask).
Menorrhagia/excessive menstruation (M,B):
Chamomile (German & Roman), cypress, rose (cabbage & damask).
Premenstrual tension/PMT (M,B,V):
Carrot seed, chamomile (German & Roman), geranium, true lavender, sweet marjoram, neroli, tarragon.
Pruritis/itching (D):
Bergamot, Atlas cedarwood, juniper, lavender, myrrh, tea tree.
Sexual overactivity (M,B):
Hops, sweet marjoram.
Thrush/candida (B,D):
Bergamot, geranium, myrrh, tea tree.
Urethritis (B,D):
Bergamot, cubebs, mastic, tea tree, turpentine.
Immune System
Chickenpox (C,S,B):
Bergamot, chamomile (German & Roman), eucalyptus (blue gum & lemon), true lavender, tea tree.
Colds/’flu (M,B,V,I):
Angelica, star anise, aniseed, copaiba balsam, Peru balsam, French basil, West Indian bay, bergamot, borneol, cabreuva, cajeput, camphor (white), caraway, cinnamon leaf, citronella, clove bud, coriander, eucalyptus (blue gum, lemon & peppermint), silver fir, frankincense, ginger, grapefruit, immortelle, juniper, laurel, lemon, lime, sweet marjoram, mastic, mint (peppermint & spearmint), myrtle, niaouli, orange (bitter & sweet), pine (longleaf & Scotch), rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, turpentine, yarrow.
Fever (C,B):
French basil, bergamot, borneol, camphor (white), eucalyptus (blue gum, lemon & peppermint), silver fir, ginger, immortelle, juniper, lemon, lemongrass, lime, mint (peppermint & spearmint), myrtle, niaouli, rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, yarrow.
Measles (S,B,I,V):
Bergamot, eucalyptus blue gum, lavender (spike & true), tea tree.... genito-urinary and endocrine systems
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