Urogenital Disorders

Urogenital disorders are problems that affect the urinary and genital tracts (reproductive organs).

Before birth, development of the urinary tract and genital tract are closely linked. The parts of the urinary tract are located near or run through parts of the genital tract. It’s common for a problem with one tract to affect or be related to the other.

The urinary tract is responsible for removing waste and extra water from the body. The urinary tract includes:

• Kidneys. A pair of organs that filter and remove waste and excess water from the blood. The byproduct is urine (pee).
• Ureters. Small tubes that carry urine from the kidneys to the bladder.
• Bladder. A muscular sac that collects and stores urine. The muscles allow control over when it’s time to empty the bladder, called urination (peeing).
• Urethra. A small tube that carries urine from the bladder out the body.

The female genital tract includes the:

• Vagina
• Cervix
• Uterus
• Ovaries
• Fallopian tubes

The male genital tract includes the:

• Penis
• Testicles
• Duct system (including the epididymis and the vas deferens)
• Accessory glands (including the prostate gland and seminal vesicles)

There are many different urogenital disorders. Some disorders are due to abnormal development of the baby during pregnancy. These are known as congenital disorders and are sometimes seen before birth using ultrasound. Others are found after delivery either during a physical exam or later in life because of another related problem.

Some types of urogenital disorders are acquired, meaning the disorder develops over time or may be the result of an infection, illness, or injury. These can be acute – they come on suddenly and get better over time. Or, they may be chronic – they develop slowly and are long-lasting or reoccur often.

Examples of urogenital disorders:

• Benign tumors. Noncancerous growth of cells. 
• Bladder exstrophy [EK-struh-fee]. A rare birth defect in which the bladder does not form correctly and may be left exposed outside the abdomen (belly). Surgery is needed to repair the defects and reconstruct other body parts.
• Cancer. Abnormal or out of control cell growth. Though generally rare in children, urogenital cancers include testicular cancer, bladder cancer, ovarian cancer, uterine cancer, and prostate cancer. 
• Hernia. An organ or other tissue pushes through weak spot in the abdomen. Common types of hernia are inguinal (inner groin), femoral (outer groin), and umbilical (belly button).
• Hydronephrosis [hi-droh-nuh-FRO-sis]. A condition where one or both kidneys swells from a buildup of urine. It can be caused by a blockage in the urinary tract or another underlying condition.
• Hypospadias [hi-po-SPAY-dee-us]. A congenital birth defect where the opening of the urethra is in the wrong place. The defect is common in males and rare in females. 
• Interstitial cystitis [in-ter-STISH-ul sis-TIE-tis]. Inflammation or irritation of the bladder wall that causes pain and pressure.
• Posterior urethral valve (PUV) disorder. A congenital birth defect where flaps of tissue form in the male urethra and block urine flow. 
• Sexually transmitted infections (STI) (also known as sexually transmitted diseases or STDs). There are multiple types of STIs that are caused by viral or bacterial infections. Left untreated, an STI can cause long-term damage to reproductive organs. More serious STIs, including HIV and hepatitis B, can cause life-long health complications.
• Undescended testes. A congenital problem where one or both testicles don’t move down from the abdomen into the scrotum. 
• Ureteropelvic junction (UPJ) obstruction. A blockage where the ureters connect to the kidney. It slows the flow of urine from the kidney and can cause kidney damage. 
• Vesicoureteral [ves-eh-co-yoo-REE-tur-ul] reflux. A disorder in which urine backs up through the ureters from the bladder. It can be caused by a birth defect or by a blockage and can lead to kidney damage.

Common signs of a urogenital disorder can include:

• Frequent urinary tract infections (UTI)
• Pain in the pelvic or groin area
• Bladder incontinence – unable to control bladder, leaks, constant urge to urinate
• Pain or discomfort while urinating
• Blood in urine
• Bad or strong smelling urine
• Reduced urine output
• Visually abnormal or malformed genitals

Other symptoms will depend on the specific disorder.

See a doctor if you or your child experiences any of the above symptoms.

In younger children, watch for signs of discomfort or for changes in bathroom use habits.

Causes will depend on the specific disorder.

Your doctor may test you for esophageal cancer if:

• You are having the symptoms of esophageal cancer
• You have one or more risk factors for this disease
• Your doctor thinks you might have esophageal cancer for some other reason

Diagnosing Esophageal Cancer

There is no standard screening test for esophageal cancer, but there are a number of tests that can help your doctor diagnose this disease:

• Esophagoscopy (ih-SOF-uh-GO-sko-PEE). During this test, your doctor puts a thin tube down your nose or throat so that they can look at your esophagus. This tube has a camera that lets the doctor take pictures or video of your esophagus. It might also have a small tool that can remove tissue samples that can be tested for cancer.
• Biopsy (BY-op-see). During a biopsy, your doctor removes a small piece of tissue from your esophagus and sends it to a lab to check for signs of cancer.
• Brush cytology (siy-TAH-low-GEE). During this test, cells are brushed from your esophagus and checked for cancer and other diseases.
• Balloon cytology. In this test, you swallow a small, deflated balloon. This balloon is inflated and pulled out of the esophagus. As it is pulled out, the balloon collects cells that can be sent to a lab to study.

Diagnosis Risks

Diagnostic tests can help your doctor diagnose esophageal cancer, but they also have some risks, including:

• The test can give a false negative: this happens when a test says you don’t have cancer, but you actually do.
• The test can give a false positive: this happens when a test says you do have cancer, but you don’t.
• The test can cause side effects, like an allergic reaction to the dye used or damage to the esophagus from the tube used for an esophagoscopy.
• Even if your doctor finds that you have cancer, it might not help you live longer.

There are six common kinds of treatment for esophageal cancer. These include:

• Surgery. If you have cancer in your esophagus, surgery is the most common form of treatment. Your doctor removes the part of the esophagus with cancer in an operation called and esophagectomy (ih-SOF-oh-GEK-tuh-mee).
• Radiation therapy. This treatment uses high-energy x-rays or radioactive particles to kill the cancer cells in your body.
• Chemotherapy (KEE-mo-THER-up-ee). This treatment uses anticancer drugs that are injected into your veins or given to you by mouth.
• Chemoradiation (KEE-mo-ray-dee-AY-shun) therapy. This treatment combines chemotherapy and radiation therapy to increase the effects of both.
• Laser therapy. A focused laser beam is used to burn away cancer cells or remove a small piece of tissue for study.
• Electrocoagulation (ee-LEK-tro-coh-AHG-you-LAY-shun). This treatment uses electricity to kill cancer cells.

Only your doctor can decide which esophageal cancer treatment is right for you. This depends on the stage of the cancer, where the cancer is in your esophagus, and other factors that your doctor can talk to you about.

There are two main ways of preventing esophageal cancer. These are avoiding risk factors that cause cancer, and increasing protective factors that help prevent cancer.

What Are the Risk Factors for Esophageal Cancer?

Risk factors for esophageal cancer include:

• Smoking
• Alcohol use
• Gastric reflux (gah-STRIK REE-fluhks) (heartburn)
• Being overweight
• Not getting enough exercise

What Are the Protective Factors for Esophageal Cancer?

Protective factors for esophageal cancer include:

• Avoiding smoking and not drinking.
• Exercising more.
• Losing weight.
• Chemoprevention (kee-MOH-prih-VEHN-shun). This is the use of drugs, vitamins, or other medicines that can reduce the risk of cancer. Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin can lower the risk of certain kinds of cancer. On the other hand, these medicines also have side effects, so you should talk to your doctor about whether this kind of prevention is right for you.

Urogenital disorders are problems that affect the urinary and genital tracts (reproductive organs). Development of the urinary tract and genital tract are closely linked so it’s common for a problem with one to affect the other. There are many different types of urogenital disorders. Some are present at birth while others may develop later in life. Symptoms and treatment will depend on the specific disorder.