Ureters. Bladder. Urethra. The urethra is female and male. I was circumcised as a child for medical reasons (phimosis), I would like to restore the appearance of my penis

Ureters– ureteres – long narrow tubes running from the hilum of the kidneys to the bladder along the lateral walls of the abdominal cavity. They enter the dorsal wall of the bladder, run obliquely for some time in the thickness of its wall between the muscular and mucous membranes and open into its cavity in the neck area. Because of this, when the bladder is stretched by incoming urine, the ureters are pinched and the flow of urine into the bladder stops. The ureters have a well-developed muscular layer. Thanks to its peristaltic contractions (1-4 times per minute), urine is driven through the ureter to the bladder.

Bladder– vesica urinaria – a hollow pear-shaped organ. It is distinguished by a cranially directed apex, the main part - the body and a narrowed, caudally directed neck. It lies unfilled for days in the pelvic cavity. When full, the top of the bladder descends into the pubic region. The neck of the bladder passes into the urethra.

Urethra– uretra – a short tube that extends from the bladder and flows into the genital tract. In females, it opens with a slit-like opening in the ventral wall of the vagina, after which the common area of ​​the urinary and genital tract is called genitourinary vestibule, or sine. In males, near the beginning of the urethra, the vas deferens flow into it, after which it is called genitourinary canal and opens on the head of the penis.

Fig. 107. Boar bladder

1 – apex of the bladder; 2 – body of the bladder (serous membrane removed); 3 – serous membrane; 4 – outer layer of the muscle membrane; 5 – middle layer of the muscular layer; 6 – inner layer of the muscle membrane; 7 – mucous membrane of the bladder; 8 – ureteral cushion; 9 – opening of the ureter; 10 – bladder triangle; 11 – ureteral folds; 12 – adventitia; 13 – sphincter of the bladder; 14 – urethral ridge; 15 – mucous membrane of the urethra; 16 – seminal mound; 17 – urethra (urethra); 18 – layer of smooth muscle tissue; 19 – urethral muscle.

Histological structure of the urinary tract. The ureters, bladder and urethra are tube-shaped organs. Their mucous membrane is lined with stratified transitional epithelium. The lamina propria of the mucous membrane is formed by loose connective tissue. The muscular layer is formed by smooth muscle tissue and is well developed, especially in the ureters and bladder, where it forms three layers: the outer and inner - longitudinal, the middle - annular. Due to the annular layer in the area of ​​the bladder neck, a sphincter is formed. Externally, the ureters and the cranial part of the bladder (apex and body) are covered with a serous membrane. The caudal part of the bladder (neck) and the urethra are covered with adventitia.

Ureter- a paired organ in the shape of a tube, with a diameter of 0.4-0.7 cm, a length of 25-30 cm. The abdominal part of the ureter starts from the pelvis, the pelvic part opens into the bladder. The ureter obliquely pierces the wall of the bladder. The structure of the wall of the ureter. The wall of the ureter consists of 3 membranes: internal - mucous, middle - muscular, external - adventitial.

Bladder(vesicaurinaria) is a hollow muscular organ designed to store urine and periodically excrete it through the urethra. The shape, size and position of the bladder depend on the degree of its filling, as well as on the condition of neighboring organs. In the absence of disease, the bladder can safely hold 300 ml of urine for 2-5 hours. The filled bubble has an ovoid shape, its average capacity is 500-700 ml.

The apex of the bladder is distinguished, facing upward and anteriorly; bottom protruding posteriorly and downward; the body - between the top and bottom and the neck - the place where the bladder passes into the urethra. The bladder is fixed by ligaments and muscles.

The structure of the bladder wall. The wall of the bladder consists of the mucous membrane, submucosa, muscularis, fascia (adventitia) and peritoneum. Mucous membrane grayish-red color, folded. In the submucosa, represented by loose, unformed connective tissue, there are networks of blood and lymphatic vessels, as well as nerve networks. Muscularis consists of 3 layers of smooth muscle fibers: external and internal longitudinal, middle - circular. Serosa(peritoneum) partially covers the bladder.

The urethra (urethra) in men has a length of about 20 cm. The circular layer of muscles in the initial part of the canal forms the involuntary internal sphincter of the urethra. In the membranous part there is a voluntary external sphincter of the canal. The external opening of the canal is located on the head of the penis and forms a small expansion here - the scaphoid fossa. The mucous membrane of the canal contains a large number of small mucous glands.

Female urethra wider than the male one, it has a slight length, up to 3-5 cm, and is a straight tube. The lumen of the canal has a star-shaped shape. At the point where it passes through the urogenital diaphragm, the urethra is surrounded by a muscle - the urethral sphincter. At the external opening of the urethra, on its sides, there are short glandular passages that open with pinholes on the outside and on the sides of the urethra - paraurethral passages.

Ureter and bladder

Bladder( vesica urinaria) is a reservoir of urine. It is located in the pelvic cavity behind the pubic fusion. The average capacity of the bubble is 600-700ml. The bladder is divided into: apex, body and bottom. The wall of the bladder consists of three membranes: mucous (3), muscular (2) and connective tissue.

The mucous membrane of the bladder has folds (5), which are absent in the area of ​​the bottom of the bladder. There is a smooth triangular section (6). At its corners, both ureters (4) open and the urethra (7) emerges. The sphincter of the bladder has the appearance of a semilunar region, and the mouths of the ureters form depressions on the sides of the triangle.

The ureter is a tube 25-35 cm long, located on the posterior abdominal wall. The ureter has abdominal, pelvic parts, as well as an intramural part, which obliquely pierces the wall of the bladder (4). The wall of the ureter also has three membranes: mucous, muscular and connective tissue.

The bottom and body of the bladder are covered with peritoneum at the back. Behind the bladder is the rectum in men, and the uterus in women.

urinary gonad internal

Female and male urethra

A woman's urethra ( urethra) is a 3-6 cm tube, which is located behind the pubic symphysis - (21). The canal is lined with mucous membrane. The canal begins at the bottom of the bladder with an internal opening, passes in front of the vagina, and opens into the vestibule of the vagina with an external opening (19) with an external sphincter.

The male urethra (bottom figure - 7) looks like a tube 16-22 cm long. It distinguishes: prostatic, membranous and spongy parts. The channel has two bends. On the posterior wall of the prostatic canal there is a seminal tubercle. It opens the ejaculatory ducts and the prostatic duct. The canal ends with the external opening of the urethra on the head of the penis (13).

The organs of the genitourinary system include:
• Urethra,
• Seminal vesicles, seminal ducts,
• Testicles and penis (in men) and vulva (in women).

From the very word " genitourinary“It becomes clear that this system consists of two components: urinary and reproductive. The combination of these two systems into one term indicates a close relationship between the organs of these two systems. The main organ of the urinary system is bud, a paired organ located retroperitoneally in the lumbar region. Urine released from the kidney enters the renal calyces, renal pelvis, and then into the ureter, which in the pelvis opens into bladder.

The urethra begins from the bladder, the structure of which differs in men and women. The reproductive system of men includes testicles with appendages, vas deferens, seminal vesicles, ejaculatory ducts, prostate gland And urethra. The external genitalia of men are presented penis and scrotum.

The female reproductive system includes the ovaries with appendages, fallopian tubes, uterus, vagina, labia majora and minora, and clitoris. Between the labia minora there is the vestibule of the vagina, into which the external opening of the urethra and the vaginal opening, as well as the ducts of the Bartholin glands, open.

		It is necessary to first determine treatment tactics with a urologist - in this case, external shock wave lithotripsy is possible (preferable for stones of a similar size). We should not forget about stone-dissolving therapy if the stone characteristics are appropriate and there are no complications (exacerbation of pyelonephritis, recurrent renal colic, etc.)
	I was circumcised as a child for medical reasons (phimosis). I would like to restore the appearance of my penis?
		You need an in-person consultation with a urologist. Similar operations are performed.

• 1. Brain matter and renal pyramids (Pyramides renales)
• 2. Efferent glomerular arteriole (Arteriola glomerularis efferens)
• 3. Renal artery (Arteria renalis)
• 4. Renal vein (Vena renalis)
• 5. Renal hilus (Hilus renalis)
• 6. Renal pelvis (Pelvis renalis)
• 7. Ureter
• 8. Small renal calyx (Calices minores renales)
• 9. Fibrous capsule of the kidney (Capsula fibrosa renalis)
• 10. Lower pole of the kidney (Extremitas inferior)
• 11. Upper pole of the kidney (Extremitas superior)
• 12. Afferent glomerular arteriole (Arteriola glomerularis afferens)
• 13. Nephron
• 14. Renal sinus (Sinus renalis)
• 15. Large renal cup (Calices majores renales)
• 16. Apex of the renal pyramid (Papillae renales)
• 17. Renal column (Columna renalis)

This is a paired organ that is located in the so-called retroperitoneal space. The shape of the buds resembles a bean (or beans). On average, the size of the kidneys in an adult is 10 x 6 cm.

They are not located in a strictly longitudinal direction, but forming a certain angle. The right kidney, due to the fact that it is located under the largest human organ - the liver - is usually located slightly lower than the left. The kidneys are surrounded by fatty tissue, which, together with the surrounding muscles and ligaments, holds them in place. This explains why thin people, as well as with sudden weight loss, can develop a disease such as nephroptosis - prolapse of the kidney.

Consist of two layers. Superficial - cortical, and deeper - cerebral. By cutting a kidney in half, you can see that it is a system of tubes. The function of these tubes is to collect urine and drain it to the pelvis. The pelvis is, as it were, a combined collector of all the tubules of the kidney. It is located in the so-called hilum of the kidney, in which, in addition to the pelvis, there is also an artery and a vein.

The main constituent unit of the kidney is the nephron. This is a glomerulus that consists of the very last “cup-shaped” section of the tube into which the capillaries flow. Blood flows through these capillaries into the glomerulus. Due to the membrane properties of the capillary walls, plasma enters the glomerulus from the blood - that is, the liquid part of the blood without red blood cells, leukocytes, etc. Normally, some blood components should not pass through the glomerular membrane: these are leukocytes, erythrocytes, as well as protein and sugar. But with certain pathologies of the kidneys and other organs, these blood components are filtered through the glomerular membrane and enter the urine.

Main kidney function- this is the “filtration” of blood. The kidneys are the main organ that cleanses the blood of all toxins and metabolic products. When they become ill, this filtering function is disrupted, which is manifested by the accumulation of metabolic products in the blood. It is worth noting that many drugs are excreted through the kidneys, both in pure and modified forms.

The main types of kidney pathology are:

Glomerular pathology: glomerulonephritis.

Inflammation of kidney components: pyelonephritis, pyelitis, etc.

Anomalies of kidney development: doublings, underdevelopment, etc.

Tumor diseases: kidney cancer.

They represent a downward continuation of the pelvis and are a tube about 30 cm long. The lumen of the ureter is 5 - 6 mm. But this width is not constant and the lumen of the ureter narrows in three places - the so-called physiological narrowings. The significance of these narrowings is that small kidney stones can get stuck in them.

The ureters empty into the bladder. The main function of the ureters is to conduct urine from the kidneys to the bladder. Conduction of urine is carried out due to involuntary peristaltic (rhythmic wave-like) contractions of the muscular lining of the walls of the ureters. Every 15 - 20 seconds, urine alternately flows from the ureters into the bladder cavity in portions. Each ureter has mechanisms that prevent the backflow (reflux) of urine from the bladder cavity when intravesical pressure increases (including when the bladder contracts during urination).

With urine reflux, the function of the ureter and kidney can be impaired. Each ureter has 3 physiological narrowings, located: (1) at the point of origin from the renal pelvis; (2) at the border of their middle and lower thirds at the intersection with the iliac vessels; (3) at the point of passage within the wall of the bladder. The presence of narrowing of the ureters is important in case of urolithiasis, when a calculus (urinary stone) that has entered the ureter from the kidney can linger at the site of narrowing, disrupting the outflow of urine through the ureter, thus causing renal colic (paroxysmal pain in the lower back and the corresponding half of the abdomen). ).

Most common diseases of the ureter c are: ureteral stones, ureteral strictures (pathological narrowing of the lumen), vesicoureteral reflux, ureterocele (cystic dilatation of the intravesical part of the ureter). Tumors of the ureter are rare.

is a pouch whose wall consists of special muscle tissue. The inside of this sac is covered with mucous membrane. The ureters (on both sides) flow into the ureter. On average, the capacity of the bladder ranges from 300 to 500, and sometimes 600 ml. Cases have been described where, due to various diseases, up to 10 liters of urine accumulated in the bladder (but this, of course, is rare).

Basic bladder pathology are: inflammation of its mucosa - cystitis, bladder stones, as well as tumor diseases (for example, bladder cancer or papilloma). In addition, there may be abnormalities in the development of the bladder. Anomalies of the bladder include: exstrophy of the bladder, anomalies of the urachus, agenesis (underdevelopment), duplication of the bladder, diverticulum (pouch-like protrusion) of the bladder, congenital contracture (narrowing) of the neck of the bladder (Marion's disease).

Urethra is a tube that serves to drain urine from the bladder. The urethra in men and women is different: in men it is long and narrow (20-40 cm long, about 8 mm wide), and in women it is short and wide (3-4 cm long, 1-1.5 cm wide). These structural features of the urethra in women are the main reason why they more often develop inflammatory diseases of the bladder - cystitis, since the infection easily enters the short female urethra into the bladder. In principle, the wall of the urethra, like the ureter, consists of several membranes. In its thickness there is a muscular layer, and the lumen of the urethra is covered with a mucous membrane. Inflammation of this membrane - urethritis - occurs as a result of infection, both banal and specific (gonorrhea, chlamydia, trichomoniasis, etc.).

Prostate- this is the “second” heart of a man. Everyone has probably heard this expression. The reason for such a scrupulous attitude towards this organ is that the prostate is involved in many processes: the formation of normal sperm, sexual function, etc. The prostate is located directly under the bladder at its neck and covers the urethra with its thickness. The prostate is a glandular organ, meaning most of its tissue is made up of glandular tissue. In shape and size, the prostate resembles a chestnut.

Main function of the prostate is the production of a special transparent liquid - prostatic juice, which makes up about 10 - 30% of the volume of sperm. The other part of the sperm is a fluid that is produced by the seminal vesicles. Prostate juice has an alkaline reaction, which is necessary to neutralize the acidic reaction of the vaginal environment and thereby ensure sperm motility.

As already mentioned, the prostate, with its thickness, covers the initial section of the urethra. This is the so-called prostatic urethra. Two prostate ducts open into it. Note that both the ducts of the prostate and the ducts of the seminal vesicles open into these openings. This arrangement prostate with its thickness covering the male urethra, it plays an important role in the manifestations of a disease such as prostate adenoma. With adenoma, as you probably know, when a benign growth of prostate tissue occurs. This leads to compression of the urethra and difficulty urinating. In addition, other types of pathology that are characteristic of the prostate are its inflammation - prostatitis, and a malignant tumor - prostate cancer.

They are peculiar convoluted sacs along the posterolateral surface of the prostate. The main function of the seminal vesicles is as a reservoir of seminal fluid. In the seminal vesicles, the seminal fluid also undergoes some changes to become full-fledged sperm. During the act of ejaculation from the seminal vesicles, seminal fluid is released through the ducts into the urethra, mixing with prostate juice. The main functions of the seminal vesicles are: (1) in the production of a significant part of the seminal fluid (up to 75% of the volume of the ejaculate); (2) in the accumulation of components of seminal fluid until the moment of ejaculation (there are usually no sperm from the seminal vesicles, and the main receptacle for sperm is the ampoules of the vas deferens); (3) in participation in the mechanism of ejaculation (at the moment of ejaculation, the contents of the seminal vesicles and vas deferens enter the urethra through the ejaculatory ducts, where they are mixed with the secretion of the prostate and discharged out). Pathology of the seminal vesicles (usually inflammation - vesiculitis) can lead to deterioration in sperm quality and infertility.

They are thin tubes that come from the testicles and flow into the seminal vesicles. Through them, seminal fluid from the testicles enters the seminal vesicles. Based on the topographical features of the vas deferens, there are 4 parts in it. The initial, shortest section, located behind the testicle, medial to its epididymis, is called the testicular part.

The next part, rising vertically upward, passes as part of the spermatic cord, medial from its vessels, and reaches the superficial inguinal ring - this is the cord part. then the vas deferens enters the inguinal canal, where its inguinal part is located. Having emerged from the inguinal canal through the deep inguinal ring, the vas deferens is directed along the side wall of the small pelvis downwards and backwards until it merges with the excretory duct of the seminal vesicle. This site vas deferens called the pelvic part. In the pelvic cavity, the duct is located under the peritoneum (retroperitoneal).

On its way, it bends around the trunk of the inferior epigastric artery from the lateral side, crosses with the external iliac artery and vein, penetrates between the bladder and rectum, crosses the ureter, reaches the bottom of the bladder and approaches the base of the prostate gland, next to the same duct of the opposite side . This terminal section of the vas deferens is dilated, fusiform in shape and forms the ampulla of the vas deferens. The length of the ampulla is 3-4 cm, its largest transverse dimension reaches 1 cm. In the lower part, the ampulla gradually narrows and, entering the thickness of the prostate gland, connects with the excretory duct of the seminal vesicle. The wall of the vas deferens consists of mucous, muscular and adventitial membranes. The mucous membrane forms 3 - 5 longitudinal folds. In the area of ​​the ampulla of the vas deferens, the mucous membrane has bay-shaped protrusions - diverticula of the ampulla. Outside the mucous membrane is the muscular layer.

The latter consists of middle circular, inner and outer longitudinal layers of non-striated (smooth muscle) cells. The muscular layer gives the wall of the vas deferens an almost cartilaginous density. In the ampulla of the vas deferens, the muscle layers are less clearly expressed. From the outside, the wall of the vas deferens is represented by the adventitial membrane, which without any clear boundaries passes into the connective tissue surrounding the duct.

They are a paired organ. They are located in the scrotum. The testicles are the “factory” for the formation of sperm. In addition, the testicles are the main organ in which the main male sex hormone, testosterone, is produced. An interesting fact worth noting is that usually the left testicle is located slightly lower than the right one.

As already noted, the main function of the testicles is the production of sperm. Sperm are produced in them by special cells - Sertolli cells. In addition to these cells, the testicles also contain Leydig cells, which produce testosterone.

Each testicle consists of lobules filled with convoluted seminiferous tubules. On each testicle there is an epididymis on top, which passes into the vas deferens. The functions of the testicle are controlled by the anterior pituitary gland. It is worth noting the fact that this location of the testicles - the main genital organs from the point of view of reproduction - is associated with a special temperature regime, which is necessary for the maturation of sperm in them.

In addition, each testicle in its half of the scrotum is covered with membranes. Sometimes, in the case of accumulation between the layers of the deepest shell of the testicle - the visceral one - dropsy (hydrocele) occurs.

Among the main testicular diseases one can note their inflammation - orchitis, as well as tumor diseases.

Structure of the penis:

1 - external opening of the urethra; 2 - frenulum of the foreskin; 3 - head of the penis; 4 - foreskin; 5 - body of the penis; 6 - superficial fascia of the penis; 7 - deep fascia of the penis; 8 - corpus spongiosum; 9 - crus of the penis; 10 - urogenital diaphragm; 11 - bulb of the penis; 12 - pubic bone.

Male penis serves for sexual intercourse and makes fertilization possible, and the urethra passes through the thickness of its spongy body, through which urine or sperm can be released. has a complex structure. In its upper part there are two cavernous bodies, and below them there is a spongy body. The cavernous bodies are covered with a connective tissue tunica albuginea.

Cavernous bodies got their name from their special cellular structure, which resembles a cave in appearance. This structure is necessary to ensure erection and sexual intercourse. Research shows that an erection occurs as a result of dilation of the arteries that bring blood to the penis, spasm of the veins through which this blood leaves the penis, and relaxation of the cells of the corpora cavernosa of the penis. Arteries, veins and cells of the cavernous bodies consist of smooth muscles. These muscles are affected by so-called neurotransmitters - substances that are released when the nerves that control the erection process are stimulated.

After appropriate sexual stimulation, these substances lead to relaxation (relaxation) of the smooth muscles of the cavernous bodies of the penis, expansion of their arterial cells, which is manifested by a powerful increase in blood flow to the penis. The cells then fill with blood, expand and compress the veins through which the blood usually drains.

General information about the excretory system. The structure of the kidneys.

The human excretory system combines a number of organs that remove urine from the body. It includes the paired kidneys and ureters, as well as the unpaired urethra and bladder. The ducts of the reproductive system open into the male urethra, so it is not only the urinary tract, but also the reproductive tract.

Kidneys– paired organs of the excretory system. They are located in the lumbar region at the posterior wall of the abdominal cavity on both sides of the spine.

The buds lie a little obliquely, since their upper ends are closer to each other than their lower ends. The right kidney is located half a vertebra below the left.

The kidney has a bean-shaped shape. It distinguishes between the anterior and posterior surface, lateral and medial edges, upper and lower pole. On the medial, concave edge of the kidney there is a groove called renal gate. The renal artery enters the renal hilum, and the renal vein and ureter exit, located behind these vessels. The renal hilum passes into the renal sinus. The renal sinus contains the renal calyces.

The substance of the kidneys consists of a cortex and medulla. The cortex occupies the periphery of the kidney and enters the medulla through renal columns. The medulla consists of 16–20 cone-shaped pyramids.

The structural unit of the kidney is nephron It is a system of tubules originating from glomerulus. This glomerulus consists of arterial capillaries surrounded by connective tissue capsule.

4/5 of all nephrons are located in the cortex. There are fewer of them in the medulla.

Of particular interest is the circulatory system of the kidneys. The renal artery, once inside the kidney, divides into a network of capillaries, and then reassembles into the outgoing artery. Thus, the network of capillaries connects not arteries and veins, but two arteries. For its uniqueness, this network is called "wonderful network"

Ureters – these are paired cylindrical tubes up to 30 cm long, which stretch from the gate of each kidney down to the bladder. The wall of the ureter is three-layered. The outer part consists of connective tissue. The middle part consists of smooth muscle tissue. The internal mucosa has many longitudinal folds, which allows the ureter to stretch.

Bladder - it is an unpaired hollow organ located in the small pelvis, behind the symphysis. The size, shape and thickness of the bladder wall depend on the degree of its filling. In the bladder, there is an apex directed upward and forward, a body - the middle part of this organ and a bottom, which makes up its lower part. The wall of the bladder consists of three layers. The elasticity of the wall allows the bladder to stretch.

Urethra has a different structure in men and women. The male urethra begins with the internal opening in the cavity of the bladder and ends with the external opening on the head of the penis. It has three sphincters, and there are three parts - prostatic, membranous and cavernous. The ejaculatory duct opens here, so the male urethra is both the reproductive and urinary tract. The length of the male urethra is 18–20 cm.

In women, the urethra is shorter than 3-4 cm. It has two sphincters and opens into the vestibule of the vagina.