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Ureteroscopy for Stone

Last Updated on Mar 20, 2020
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Ureteroscopy - Anatomy & Function

"Bones can break, muscles can atrophy, glands can loaf, even the brain can go to sleep without immediate danger to survival. But should the kidneys fail...neither bone, muscle, gland nor brain could carry on." - Dr. Homer Smith in his book, "Fish to Philosopher."

The organs, tubes, muscles, and nerves that work together to make, store, and carry urine make up the urinary system. The urinary system consists of two kidneys, two ureters, the bladder, and the urethra.

Kidneys: They perform vital functions and many other organs in our body depend on the kidneys in order to function. A person normally has two kidneys, one on either side of the back under the lower ribs.

Kidneys are shaped like kidney beans hence called “kidneys”. Each kidney is about 4 to 5 inches long and 2 to 3 inches wide. Each kidney is made up of small, complex units called nephrons. The two kidneys contain about two million nephrons. The nephrons work continuously to filter out waste products from the blood stream, all of which come from the food that one eats and the fluid that one drinks.

Kidneys are the master chemists of the body and regulate the amount of water that should stay in the body. The chemicals and wastes that accumulate have to be discarded and kidney tends to do this very precisely. Normally 200 liters of water are filtered through the kidney daily and only about 2 liters are passed as urine.

Ureter: From the kidneys, urine travels down two thin tubes called ureters, leading away from each kidney to the urinary bladder. The ureters are about 24 – 30 cm long and the thickness is about 3 mm. The muscles in the walls of the ureter constantly tighten and relax to empty the urine from the kidneys. Small amounts of urine are emptied into the bladder from the ureters about every 10 to 15 seconds.

Ureter is divided into upper, middle and the lower third. It has a long course in the body by the side of the spinal cord. It has three narrow areas where the stones tend to get stuck. These narrow areas include –

Anatomy of the Kidney
  • The junction between the pelvis of the kidney and the ureter.
  • The middle third where it crosses over large vessels of the pelvis.
  • The lower third – where the ureter meets the urinary bladder.
The urinary bladder is responsible for storing the urine produced and for letting it out at regular intervals. It sits in your pelvis and it stores urine until you are ready to empty it. It swells into a round shape when it is full and gets smaller when empty. If the urinary system is healthy, the bladder can hold up to 450 – 500 ml of urine comfortably for 2 to 5 hours.

The nerves in the bladder tell you when it is time to urinate (empty your bladder). As the bladder first fills with urine, you may notice a feeling that you need to urinate. As the bladder fills with more and more urine over a period of time, sensation to urinate becomes stronger. At that point, nerves from the bladder send a message to the brain that the bladder is full, and your urge to empty your bladder intensifies. After the brain has received the signal, it sends back an message to the urinary bladder whether it can let out the urine or not. For example, if you feel like passing urine when you are in a important meeting, you will be able to control your desire to urinate or the urge to pass urine to some degree until it is convenient to pass urine. This is because the brain has given a signal to wait for some time till it is convenient to pass urine.

When it is convenient, the brain signals the muscles of the urinary bladder to tighten which would help to squeeze the urine into the urethra through which the urine is taken out from the body.


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