Genitourinary System

Dr Kaneez Sadia; PT
The University of Faisalabad
Date: 12-11-2018
 Learning objectives
1. Basic understanding of the structure and
function of the genitourinary system
2. Information about the clinical evaluation of
the genitourinary system, including physical
examination and diagnostic studies
3. A basic understanding of the various diseases
and disorders of the genitourinary system
 Learning objectives
4.Information about the management of
genitourinary disorders, including dialysis
therapy and surgical procedures
5.Guidelines for physical therapy intervention in
patients with genitourinary diseases and
disorders
Genitourinary System
 Primary functions of the genitourinary
system
1. Excretion of cellular waste products (e.g., urea, creacinine
and ammonia) through urine formation and micturition
(voiding)
2. Regulation of blood volume by conserving or excreting
fluids
3. Electrolyce regulation by conserving or excreting minerals
4. Acid-base balance regulation
5. Arterial blood pressure regulation
6. Erythropoietin secretion
7. Gluconeogenesis
 Clinical Evaluation
• Physical Examination
• History
• Observation
• Palpation
• Percussion
• Auscultation
 Diagnostic Tests
• Urinalysis
• Creatinine Tests
• Blood Urea Nitrogen
• Radiographic Examination
• Pyelography
• Renal Arteriography alld Venography
• Bladder Examination: Cystoscopy and
Panendoscopy
 Urodynamic Studies
• Uroflowmetry
• Cystometrogram
 Radioisotope Studies
• Renography
• Renal Scan
• Nuclear Cystogram (Radiollllclide Cystogram)
• Ultrasonography Studies
• Computed Tomography
 Biopsies
• Renal Biopsy
 Pathophysiology
• Renal System Dysfunction
• Acute Renal Failure
• Chronic Renal Failure
• Pyelonephritis
• Chronic Pyelolephritis
• Glomerulonephritis
• Post infectious glomerulonephritis
• Chronic Glomerulonephritis
• Nephrotic Syndrome
• Diabetic Nephropathy
 Renal Vascular Abnomalities
• Renal Artery Stenosis or Occlusion
• Renal Vein Thrombosis
 Urinary Tract Dysfunction
• Cystitis
• Urinary Calculi
• Neurogenic Bladder
 Prostate Disorders
• Benign Prostatic Hypertrophy
• Prostatitis
 Management
• Renal Replacelllent Therapy
• Peritoneal Dialysis
• Intermittent Hemodialysis
• Continuous Renal Replacement Therapy
• Surgical Interventions
1. Nephrectomy
2. Open Prostatectomy
3. Transurethral Resection
 Physical Therapy goals
1. Optimize safe functional mobility
2. maximize activity tolerance and
3. Endurance prevent postoperative pulmonary
complications.
 Physical Therapy Intervention
• Evaluating laboratory values before
examination or intervention can help the
physical therapist decide which particular
signs and symptoms to monitor as well as
determine the parameters of the session.
 Physical Therapy Intervention
• Mental status changes from a buildup of
ammonia, BUN,Cr, or a combination of these.
If this situation occurs, then the therapist may
choose to modify or defer physical therapy
intervention, particularly educational activities
that require concentration.
 Physical Therapy Intervention
• Disruption of excitable tissues such as peripheral
nerves and skeletal, cardiac, and smooth muscle
from altered levels If this situation occurs, then the
therapist may need to reduce exercise intensity
during muscle strengthening activities.
• Additionally, if peripheral neuropathy results in
sensory deficits, then the therapist needs to take
the appropriate precautions with the use of
modalities and educate the patient on protective
mechanisms to avoid skin breakdown.
 Physical Therapy Intervention
• Peripheral or pulmonary edema from inability
to excrete excess body fluids
• Pulmonary edema can result in shortness of
breath with activities and recumbent
positioning.
• Peripheral edema can result in range-of-
motion limitations and skin breakdown.