Urinary system diseases

　　The etiology is complex and diverse: male urinary tract infection refers to diseases caused by bacterial, viral, or parasitic infections in the male reproductive system (urethra, prostate, epididymis, vas deferens, seminal vesicle, testicles, etc.). Most male reproductive tract infections are caused by external bacterial invasion and infection, often leading to orchitis, epididymitis, prostatitis, seminal vesiculitis, urethritis, and other conditions. Pathogens that can cause reproductive tract infections include gonococcus, tuberculosis bacilli, viruses, mycoplasma, chlamydia trachomatis, trichomonas, and other non-specific pathogenic bacteria, among which mycoplasma and chlamydia are the most common causes of reproductive tract infections.

　　Urogenital system infection This refers to urethral and bladder infection. The channel through which urine from the bladder is excreted to the outside is called the urethra. The urethra and bladder are closely connected, and urethral infection often leads to bladder inflammation. Generally speaking, urogenital system infection is often related to poor hygiene, about 50% of women have had at least one urogenital system infection, and 20% of women have multiple infections - many women have 1-2 infections per year, which is very common. Urogenital system infection originates from Escherichia coli, which inhabit the vagina and then occupy the urethra. When in the vagina, these bacteria are harmless, but the problem begins when they enter the urethra. These bacteria are present in all women. Women with urethral infection have the same body structure as other women. For some unknown reasons, some women are more susceptible to infection. Some women's urogenital system infections are the result of injury during sexual intercourse; men can also get this disease, but it is relatively rare, and male urogenital system infection is usually caused by sexually transmitted diseases. Non-specific urethritis and gonorrhea are the two sexually transmitted diseases that most commonly cause urethral and bladder inflammation.

　　Prostate diseases Prostate hyperplasia and prostatitis are common diseases of the male prostate. Prostate hyperplasia is one of the common diseases in elderly male patients. With the increase of age, men have varying degrees of prostate hyperplasia. Studies have shown that prostate hyperplasia begins after the age of 40, but it is more common in elderly people over the age of 60. The main symptoms of prostate hyperplasia include difficulty in urination, mild cases may have more frequent nocturnal urination, feeling of incomplete urination, or a small amount of urine remaining after urination; severe cases may have a thin urine stream, or even be unable to urinate; at the same time, it is often accompanied by symptoms such as lower back pain, weakness of the limbs, seminal emission, and others. Severe cases of prostate hyperplasia must be surgically removed, and general conservative treatments, including hand massage, are not very satisfactory.

　　Prostatitis is divided into acute and chronic types. Acute prostatitis is mainly characterized by bladder irritation symptoms, terminal hematuria, and perineal pain, but it is relatively rare in clinical practice. Chronic prostatitis is mainly characterized by delayed urination, post-urination dripping, or secretion of white prostatic fluid, or causing seminal emission, impotence, premature ejaculation, and other symptoms. Patients with chronic prostatitis account for 30% to 50% of urological outpatient departments, among whom patients aged 20 to 40 account for 50% to 80%.

　　Hand massage has a good therapeutic effect on chronic prostatitis and benign prostatic hyperplasia. Since there is no effective treatment for such diseases at present, the use of hand massage therapy is even more meaningful. Hand massage can stimulate and enhance the function of the prostate, while strengthening the urinary system's urine excretion function, thereby restoring its normal function.

　　One, Urinary System Tumor

　　Tumors occurring at any location in the urinary system. Including kidney, renal pelvis, ureter, bladder, and urethra tumors. Below the renal pelvis are the tubular organs, which are all covered with urothelium (also known as transitional epithelium), and the internal environment they contact is urine. Carcinogenic substances often cause tumors in the urothelium through urine, so the urothelial tumors of the renal pelvis, ureter, bladder, and urethra all have common characteristics and may occur in multiple organs. Since urine stays in the bladder the longest, bladder cancer caused by it is the most common.

　　Tumors in the urinary system often occur after the age of 40, and men are about twice as many as women. Nephroblastoma and bladder rhabdomyosarcoma are diseases in infants and children, with no difference in incidence between males and females. In urinary system tumors, the incidence of renal cell carcinoma in China is higher than that in Europe and the United States.

　　Two, Kidney Tumor

　　For many years, it was believed that 90% of kidney tumors were malignant, but with the progress of medical imaging, especially the advent of B-ultrasound, CT, and magnetic resonance, it is often found that benign lesions (such as renal cysts) and benign tumors (such as angiomyolipomas) exist in the kidneys, and the statement that 90% of kidney tumors are malignant is questioned.

　　Three, Urinary System Stones

　　Occurring in urinary system stones. Also known as urolithiasis. It includes kidney, ureter, bladder, and urethra stones. The incidence of urolithiasis has significant regional differences, with many high-risk areas in the world. The incidence in southern China is much higher than in the north. The incidence in Dongguan, Guangdong, reaches 1.6‰, which is rare. The occurrence and development of urolithiasis are closely related to nutritional status. In poor and backward countries, plant proteins are the main food, and phosphates are lacking in urine, which is easy to cause bladder stones, especially common in children, while in developed countries, calcium-containing renal stones in adults are more common. There are many theories about the formation of uroliths, such as nucleation theory, matrix theory, and crystallization inhibitor theory, but no theory can fully explain the formation mechanism of all uroliths. Obstruction, foreign bodies, and infection in the urinary system can promote the formation of uroliths, and conversely, uroliths can also be the cause of obstruction and infection. Metabolic diseases such as hyperparathyroidism, gout, oxalate, and cystine metabolic abnormalities can also be the cause of urolith formation.

　　Four, Acute Nephritis Syndrome

　　1, Most often caused by Streptococcal infection

　　Clinical characteristics: hematuria, proteinuria, edema, hypertension, and azotemia.

　　2, Acute Progressive Nephritis Syndrome

　　Clinical characteristics: more acute onset with hematuria, proteinuria, edema, hypertension, and azotemia.

　　Five, Glomerulonephritis

　　Glomerulonephritis refers to a group of diseases with similar clinical manifestations (such as hematuria, proteinuria, hypertension, etc.), but with different etiology, pathogenesis, pathological changes, course, and prognosis. The lesions mainly affect the glomeruli of both kidneys. It can be divided into primary, secondary, and hereditary types. Primary glomerulonephritis often has an unknown cause, secondary glomerulonephritis refers to glomerular damage in systemic diseases, and hereditary glomerulonephritis is caused by genetic gene mutations.

　　Primary glomerulonephritis is divided into five clinical types:

　　1. Acute glomerulonephritis.

　　2. Acute progressive glomerulonephritis.

　　3. Chronic glomerulonephritis.

　　4. Latent glomerulonephritis [asymptomatic hematuria or (and) proteinuria].

　　5. Nephrotic syndrome.

　　1. Patients with obvious urinary system symptoms:The main symptoms include changes in urination, such as frequent urination, urgency, dysuria, enuresis, and difficulty in urination; changes in urine, such as hematuria, pyuria, chyleuria, etc.; and pain that is obviously related to urinary system organs or areas, such as renal colic, bladder pain, etc. If the patient has such symptoms, a preliminary diagnosis can be made by combining the medical history and general manifestations. With routine urine examination and targeted special examinations such as X-rays, B-ultrasound scanning, and endoscopic examination, the diagnosis can be confirmed. Patients with urinary system infections, stones, tumors (especially bladder tumors) mostly belong to this category.

　　2. Patients with systemic symptoms but no obvious urinary system symptoms:Patients may only have fatigue, decreased appetite, weight loss, low fever, and increased blood pressure, without obvious urinary system symptoms. In this case, the disease is easily ignored. For example, patients with chronic glomerulonephritis may have no obvious urinary system symptoms for a long time, until renal insufficiency appears, often due to poor appetite or anemia. Some renal tumor patients may not have typical symptoms such as hematuria, mass, and pain, but only present with low fever. When there are no urinary system symptoms, routine urine examination can often provide important clues. For example, proteinuria in chronic glomerulonephritis and increased red blood cells in urine during tumor (microscopic hematuria) are of great help to diagnosis. When the reasons for low fever, anemia, edema, and hypertension are uncertain, urine examination should be paid attention to, and necessary repeated examinations or Eddington's count and other examinations should be carried out. Systemic diseases such as diabetes, gout, and occupational diseases can all cause secondary kidney disease, and drugs can also cause kidney damage, so attention should be paid not to miss the diagnosis.

　　3. Urinary system diseases without symptoms:Early diagnosis and treatment of diseases are very important. Therefore, regular health checks are extremely important, and health checks for urinary system diseases should include digital rectal examination (to understand the condition of the prostate), routine urine examination, and B-ultrasound examination of the renal area. B-ultrasound examination can detect renal cancer with a diameter less than 2cm, and timely surgical treatment is beneficial to improve the efficacy. Urinary system diseases without symptoms should be paid attention to.

　　1. Pay attention to personal hygiene:Pay attention to personal hygiene to prevent bacteria from entering and infections. Wear cotton underwear and pants to keep yourself dry, avoid tight, non-breathable pants, and change your underwear frequently. Do not bathe in public bathhouses or bathtubs, do not sit on toilets that have not been disinfected, and do not share a towel with others.

　　2. Drink more water:The longer urine stays in the bladder, the more bacteria there are - the number of E. coli doubles every 20 minutes. The more bacteria, the more uncomfortable. Therefore, the best way to relieve urethral pain is to drink more fluid to flush out the bacteria that cause inflammation. If the urine is clear, it means you are drinking enough water. If the urine has a color, it means you are not drinking enough water.

　　3. Avoid rough actions:Clean the body before sexual intercourse, especially the husband should be affectionate, and avoid rough actions that may hurt the wife.

　　4. Wipe from the back:After defecation, wiping from front to back can prevent infection. Incorrect wiping method is one of the most common causes of infection, and it is also easy to cause recurrence. Of course, you hope to wipe the bacteria away from the outside, not to wipe them into the vagina and urethral opening.

　　5. Take a hot bath:This can help alleviate pain, and a hot bath is usually beneficial for inflamed areas.

　　6. Use sanitary napkins:Why are women more prone to infection, which may be related to sexual intercourse, insertion of contraceptives, and tampon use, which involve contact with the vagina and seem to increase the risk of infection. It is recommended that patients with chronic infections during their periods replace tampons with sanitary napkins.

　　7. Do not overclean:Too frequent sitting in the bath is also not good. Long-term flushing may introduce bacteria into the vagina, while washing away the normal benign bacteria, allowing infectious E. coli to take over. There may also be urethral discomfort, feeling like a urinary tract infection. Irritating disinfectant soap may also lead to the same result - changing the vaginal flora, making it more susceptible to infection.

　　8. Aspirin eye drops for inflammation may be helpful to some people:It can alleviate bladder inflammation. Less inflammation means less burning sensation.

　　9. Nutritional supplementation:Taking about 1000 milligrams of vitamin C (taken in several doses) each day is enough to acidify urine to interfere with bacterial growth. If you have a recurrence or relapse and have nowhere to seek medical help, this is a good method. Note: Sometimes, the antibiotics prescribed by doctors for urinary system infections may not work in acidic urine, so if you are taking vitamin C, you should inform your doctor. You should also inform them of the amount you are taking. Vitamin C is not toxic, but 1000 milligrams a day is considered a high dose and should be prescribed by a doctor.

　　10. Risk signals:Patients with bladder infection showing the following symptoms should see a doctor as soon as possible: hematuria, lower back and lumbar pain, fever, nausea or vomiting.

　　1. What are the items to be checked for urinary system infection?

　　1. Normal urinary system infection, the urine occult blood test is negative. If urine occult blood is positive and protein is present, kidney disease and bleeding disorders should be considered first, and further renal function tests can be performed; if the urine protein is negative, it should be investigated by relevant specialists to determine the location and nature of the bleeding. It is generally believed that lower urinary tract bleeding may not be evident due to the unbroken red blood cells.

　　2. Normal urine routine examination generally has no protein, or only trace amounts. An increase in urinary protein and its persistent appearance is more common in kidney diseases. However, proteinuria may occasionally occur due to fever, intense exercise, or pregnancy. Therefore, when protein is present in urine, it is necessary to trace and observe to clarify the cause.

　　3. Urinary glucose should be combined with clinical analysis, which may be diabetes or renal glycosuria caused by a decrease in the renal glucose threshold. For the diagnosis of urinary system infection, it should be combined with blood glucose testing and other examination results to make a clear diagnosis. Since vitamin C and aspirin in urine can affect the results of urinary glucose, vitamin C and aspirin should be stopped 24 hours before the urine glucose test.

　　4. The presence of a small amount of epithelial cells in urine has little clinical significance; when a large number of epithelial cells appear, if vaginal secretion contamination can be excluded, it should be considered that there is a urinary system inflammation. At this time, if the urine epithelial cell morphology examination is added, the source of the epithelial cells can be determined.

　　5. If there are more than 5 red blood cells per high-power microscopic field of urine, it is called microscopic hematuria; when there are a large number of red blood cells, it is called 'gross hematuria', which can be seen in urinary system inflammation, infection, stones, tumors, and so on. It should be paid attention to, and an immediate visit to a urological specialist is recommended for further examination to clarify the location and cause of hematuria.

　　6. For the diagnosis of urinary system infection, if there are more than 5 white blood cells per high-power microscopic field of urine, it is called leukocyte urine. When there are a large number of white blood cells, it is called purulent urine, indicating urinary tract infection, such as pyelonephritis, cystitis, urethritis, and so on.

　　Secondly, what examinations are needed for the diagnosis of urinary system infection

　　1. Radiological examination: Including abdominal X-ray film, intravenous pyelography, retrograde pyelography, renal tomography, and renal arteriography, etc., which is of great value for understanding morphological changes and function.

　　2. Antibody-coated bacteria test: The bacteria in the urine of patients with pyelonephritis are often coated with human IgA. The application of fluorescent-labeled anti-IgG immunoglobulin to the bacteria coated with antibodies can show a ring-shaped fluorescence around the bacteria, which is positive. This method is helpful for diagnosing pyelonephritis, while it is negative for cystitis.

　　3. Renal biopsy: It can provide pathological morphological data, which is the basis for pathological morphological diagnosis, prognosis, and reasonable treatment. However, it has certain limitations, the obtained tissue is small, and it may not be effective for diagnosing focal lesions. Many secondary glomerular diseases rely solely on renal biopsy pathological morphology.

　　4. Radionuclide examination: Isotope tomography can understand kidney morphology and renal non-functional areas. Isotope renal imaging can help understand the renal blood flow excretion function of the side kidney and whether there is urinary tract obstruction.

　　5. Ultrasonic examination: It is very valuable to understand whether there are stones, kidney morphology, renal pelvis effusion, and tumors in diagnosing urinary tract infections.

　　1. 100 grams of plantain seed, 10 grams each of bamboo leaf heart and raw licorice, with appropriate amount of sugar, decocted as tea, one dose per day. This formula has antibacterial and antiviral effects, and is effective for urinary tract infections, viral hepatitis, and other conditions.

　　2、鲜绿豆芽500克，榨汁加白糖适量。频饮代茶，不拘量。此方对尿路感染、小便赤热、尿频等症有疗效。

　　2, Fresh mung bean sprouts 500 grams, juiced with an appropriate amount of sugar. Drink frequently as tea, without restrictions on quantity. This recipe is effective for urinary tract infection, red and hot urine, frequent urination, and other symptoms.

　　3, Fresh bamboo leaves, white mugwort root each 10 grams, placed in a thermal cup, infused with boiling water, covered for 30 minutes, and taken as tea frequently. This recipe is suitable for urinary tract infection and the presence of red blood cells in the urine.

　　4, Raw Astragalus, white mugwort root each 30 grams, Cistanche deserticola 20 grams, watermelon skin 60 grams, decocted with an appropriate amount of sugar. Take 2-3 times a day. This recipe invigorates the qi, benefits the kidneys, promotes diuresis, and eliminates swelling. It has a special effect on urinary tract infection.

　　5, Fresh sugarcane 500 grams, peeled and chopped, juiced; tender lotus root 500 grams, peeled and chopped, take the juice and mix with sugarcane juice, drink it 3 times a day. This can treat symptoms such as red and hot urine.

　　6, Fresh Prunella vulgaris 60-90 grams (20-30 grams of dried product), pork small intestines 200 grams, a little salt. Cut the pork small intestines into small pieces, add an appropriate amount of water and Prunella vulgaris to boil in a pot, season with salt, drink the soup and eat the pork small intestines. Twice a day. This recipe is suitable for dysuria, frequent urination, urgent urination, and hot pain caused by acute cystitis.

　　Focus on prevention:

　　1, It should be emphasized that urinary system diseases should be prevented. Preventing streptococcal infection and avoiding or reducing upper respiratory and skin infections can significantly reduce the incidence of glomerulonephritis. Prompt treatment of urinary tract obstruction due to various causes can help reduce bacterial infection and reduce secondary urinary tract stones. The epithelium covering the renal calyces, renal pelvis, bladder, and posterior urethra are all transitional epithelial cells. In urinary system tumors, transitional cell carcinoma occupies a dominant position, and not smoking can reduce the incidence of this type of cancer. For urinary stones, it is necessary to prevent causes that can be resolved, such as hyperparathyroidism; and to reduce the intake of foods containing urinary stone components (such as emphasizing the avoidance of high-nucleoprotein foods for patients with uric acid stones) for prevention. Increasing fluid intake to dilute the concentration of salts in urine has a certain preventive effect on various types of stones.

　　2, Endoscopic diagnosis and treatment of urinary system diseases plays an important role in urological work. Based on cystoscopy and ureteroscopy, nephrosopy (pelvioscopy) has also become a routine diagnostic and therapeutic tool in recent more than 10 years, forming a professional field of 'endoscopic urology'. Through the use of a transurethral resection scope (a specialized cystoscopy for the bladder and urethra), most patients with prostate obstruction can undergo electroresection through endoscopy instead of open surgery, which can alleviate the burden on patients. Combined with ultrasound or electrohydraulic effect, stones can be crushed and removed through endoscopy for therapeutic purposes. Therefore, the development of endoscopic urology has reduced the need for surgical treatment of stones. Similarly, bladder cancer can also be treated by electroresection through cystoscopy instead of partial cystectomy. Of course, there are indications for endoscopic urological treatment, which cannot completely replace surgery.

　　3. Extracorporeal shock wave lithotripter is a new technology and machine developed in West Germany in the 1970s and applied in clinical practice in the 1980s. Through the medium of water, the energy produced by electric sparks or piezoelectric ceramics is transmitted into the body to crush urinary tract stones, allowing them to be excreted from the body naturally. This technology, which allows external energy to enter the body to achieve a therapeutic effect, is a major innovation in medicine. This technology has expanded from crushing urinary tract stones to crushing gallstones, and it is currently being studied whether it can be applied to other diseases. The emergence of extracorporeal shock wave lithotripsy has completely changed the indications for traditional surgical treatment of stones. Extracorporeal shock wave lithotripsy does not require open surgery and also does not require anesthesia, and treatment can be performed on an outpatient basis. China has developed its own extracorporeal shock wave lithotripter in the mid-1980s, and has gained its own experience in extracorporeal shock wave lithotripsy, and some of the specific application methods have been promoted worldwide. Although extracorporeal shock wave lithotripsy is a breakthrough in treatment technology, it still has its indications and complications, and is prone to recurrence. The current focus of research is on how to correctly combine it with endoscopic urological methods and surgical treatment to reduce complications and recurrence.

　　4. Kidney transplantation and dialysis therapy are two effective measures for treating end-stage renal failure, known as renal replacement therapy. At the same time, dialysis therapy is also an important treatment for reducing mortality in some patients with acute renal failure. In organ transplantation work, kidney transplantation ranks first in terms of practical value, technical maturity, and transplantation outcomes. Artificial kidney, also known as hemodialysis therapy, includes hemodialysis, hemofiltration, hemoperfusion, among which hemodialysis is the main method. Currently, about 500,000 people worldwide rely on hemodialysis to maintain their lives, among whom some patients can maintain light or intellectual labor. In recent years, China's artificial kidney technology has also made significant progress. Peritoneal dialysis is simple and easy to perform, does not require special equipment, and has a good effect on acute renal failure. For chronic renal failure, the adoption of non-bedridden continuous ambulatory peritoneal dialysis (CAPD) as maintenance therapy has also seen significant development. Since the course of chronic renal failure is long and has the characteristic of gradual deterioration, it is of great significance to adopt non-dialysis therapy before renal function is completely lost and dialysis treatment is not required, to prevent or delay the progressive deterioration of renal function. In recent years, research in this area has begun to be paid attention to, and various treatments have been carried out, including nutrition, metabolism, and the use of erythropoietin for anemia treatment. China has also carried out integrated traditional Chinese and Western medicine treatment, and it has been confirmed that some measures can delay the progression of the disease, thus opening up new prospects for treatment before the end-stage of chronic renal failure.

　　5. The significance of the development of new technology, in recent years, due to the development of immunology, molecular biology, and cell biology, some new technologies have played an important role in the prevention and treatment of kidney disease. For example, the study of genes has enabled the cloning of the gene defect in the glomerular basement membrane of Alport's syndrome, a hereditary kidney disease, which is helpful for early diagnosis in the embryonic stage. There is also a similar situation with polycystic kidney disease. Since many kidney diseases are considered to be related to genetic genes, the approach to prevention and treatment from this aspect will gradually become a reality.

　　6. The immune mechanism of kidney disease, after decades of research, medicine has accumulated a large amount of knowledge, and the corresponding immunosuppressive therapy developed accordingly has made it possible to cure or alleviate various kidney diseases, and has also made kidney transplantation a reality. However, the current immunosuppressants are non-specific, that is, while inhibiting 'harmful' cells, they also inhibit other normal cells, leading to many adverse consequences, which is an urgent problem to be solved. Since various cells of the kidney tissue can currently be separated, most of which can be cultured in vitro for experiments, it provides a broad prospect for exploring new preventive and therapeutic measures. Other non-immune mechanisms, such as the common glomerulosclerosis, its formation has some other mechanisms to be studied, according to research, protein metabolism, lipid metabolism, etc., may have an important impact, and also provides clues for the prevention and treatment of this aspect.