GENITOUNARY

Anatomy and Physiology

Urinary system (illustration )

1. Kidney
a. structure (illustration )
i. cortex (outer layer): glomeruli, proximal and distal tubules
ii. medulla (middle layer): about eight renal pyramids formed by
collecting ducts and tubules
iii. renal pelvis (innermost layer): composed of calyces where papillae
move urine into the ureter by peristalsis
iv. nephron: functional unit that filters, concentrates, reabsorbs and
secretes to produce urine (illustration 1 illustration 2 )
v. glomerulus: filters fluid wastes out of the blood (plural: glomeruli)
vi. tubules (proximal, Henle's loop, distal): here fluid is made into urine
b. functions
i. fluid and electrolyte balance
ii. acid-base balance: HPO4 buffer system, NH3 buffer system
iii. to regulate arterial blood pressure: renin, aldosterone
iv. to excrete waste products: urea, creatinine production of
erythropoietin
2. Ureters
a. convey urine from pelvis of the kidneys to the bladder
b. consists of smooth muscle, moves by peristalsis
3. Bladder - stores urine (illustration )
4. Urethra
B. Reproductive system - male (illustration )
1. Testes: main male sex glands (illustration )
2. Each testis is encased in a fibrous capsule which has partitions into the inner gland
3. Seminiferous tubules form spermatozoa (illustration )
4. Interstitial cells secrete testosterone
5. Accessory glands
a. seminal vesicles
b. prostate gland
c. bulbourethral glands secrete lubrication prior to ejaculation
6. Ducts
a. epididymis conducts semen from testes to vas deferens
b. vas deferens conduct semen from each epididymis to an ejaculatory duct
(illustration )
c. ejaculatory ducts
d. urethra
7. Scrotum
8. Penis
C. Reproductive system - female (illustration 1 illustration 2 illustration 3 )
1. Ovaries
a. consist of graafian follicles in which ova develop
b. functions of ovaries:
i. oogenesis (illustration )
ii. ovulation (illustration )
iii. secretion of progesterone and estrogen
2. Fallopian tubes - conduct ova from ovaries to uterus
3. Uterus functions in menstruation and pregnancy
4. Vagina (illustration )
 5. Vulva (illustration )
6. Breasts

II. Prostate Disorders

A. Benign prostatic hyperplasia (BPH)
1. Definition - enlargement of the prostate gland
2. Etiology
a. occurs as men age
b. associated with circulating androgens
c. as prostate enlarges, prostatic tissue forms nodules
d. prostate becomes spongy and thick
e. prostatic urethra narrows via compression
f. impedes passage of urine
B. Findings
1. early stages often asymptomatic as enlargement occurs
2. changes in micturition
3. nocturia
C. Diagnostics
1. rectal examination
2. urinalysis
3. serum creatinine and BUN studies
4. serum PSA
D. Management
1. if asymptomatic, follow annually
2. use the following medications as indicated:
a. beta blockers
I. prazosin (Minipress) - to decrease findings of prostatic hyperplasia
urinary urgency, hesitancy, nocturia
II. doxazosin (Cardura)- management of the findings of BPH
b. hormonal manipulation
I. finasteride (Proscar) - decrease prostate size with associated decrease
in urinary findings
II. terazosin (Hytrin) - management of outflow obstruction in clients
with BPH; decreases findings
c. to relieve symptoms temporarily, use balloon dilation
d. surgery if indicated:
I. TURP transurethral resection of prostate
II. open prostatectomy
III. laser surgery
IV. insertion of prostatic stent
3. Complications
a. acute urinary retention
b. involuntary bladder spasms (contractions)
c. hydronephrosis
d. urinary tract infection (see below)
e. gross hematuria
4. Nursing interventions
a. assessment
I. history of current signs and symptoms
II. assess abdomen for distention of the bladder
III. measure postvoid residual (if needed)
IV. assess for infection, hematuria
V. if beta blockers are used check sitting and standing blood pressures
weekly while titrating dose
b. facilitate urinary elimination (illustration )
c. provide privacy for patient
d. monitor intake and output, wieghts
 e. maintain catheter patency (if in use)
f. medicate as prescribed by health care provider
E. Prostate cancer
1. Definition: malignant neoplasm, usually adenocarcinoma, of prostate gland
2. Etiology
a. more prevalent in African American men
b. most appear on the peripheral zone of the gland
c. most are palpable on rectal examination
d. spreads via lymphatics, bloodstream or by local extension
e. specific etiology unknown; familial history increases risk
3. Findings
a. usually asymptomatic in early stages
b. obstruction of urinary flow
c. pain represents location of metastases
I. lumbosacral
II. hips
III. lower legs
d. rectal discomfort
e. weight loss
f. anemia
g. edema of lower extremities
4. Diagnostics
a. digital rectal examination
b. needle biopsy
c. transrectal ultrasonography
d. serologic markers
I. PSA
II. prostatic acid phosphatase
III. descending urography
e. metastatic evaluation:
I. chest x-ray
II. IVP
III. CT scan
IV. MRI
5. Management
a. conservative approach
I. usually no treatment for men over 70 due to slow progression
II. analgesics and narcotics to manage pain
III. short course of radiotherapy (site-specific)
IV. IV administration of strontium chloride 89 (beta emitter agent)
V. TURP in cases of bladder obstruction
VI. placement of suprapubic catheter
b. surgical approach
I. radical prostatectomy
II. laparoscopic dissection of pelvic lymph node
III. cryosurgery
c. curative approach
I. external beam radiation
II. interstitial radiation
d. palliative approach
I. hormone manipulation
I. estrogen therapy diethylstilbestrol (DES)
II. luteinizing hormone-releasing hormone (LHRH)
II. bilateral orchiectomy (removal of the testes)
III. use of anti-androgen drugs
I. megestrol acetate (Megace) - antineoplastic decreases the
growth of prostate carcinoma, an androgen-sensitive tumor
II. flutamide (Eulexin)
III. drugs are often used in combination therapy
6. Complications
 a. bone metastases
b. complications of hormone manipulation
I. nausea and vomiting
II. gynecomastia
III. sexual dysfunction
IV. hot flashes
7. Nursing interventions
a. assessment
I. history of current symptoms
II. examine abdomen for palpable nodes
III. flank pain
IV. bladder distention
b. control pain
c. reduce anxiety
d. discuss potential changes re: sexual functioning

III. Female Reproductive Disorders

A. Cystocele
1. Definition - bladder herniates into vagina

2. Etiology
a. associated with obstetrical trauma
b. may be due to a congenital defect
c. findings may appear after hysterectomy
d. may appear as genitalia atrophy with age
3. Findings
a. in early stages, asymptomatic
b. pelvic pressure
c. changes in micturition

Don't be confused by the names: Cystocele is a hernia, but Endometriosis is cysts.

Cystocele - hernia (bladder into vagina)
Endometriosis - cysts of uterine tissue

4. Diagnostics
a. pelvic examination
b. urinalysis and culture
5. Management
a. in postmenopausal client, estrogen therapy
b. insertion of vaginal pessary to support pelvic organs
c. surgical Intervention (if indicated)
i. to restore bladder function
ii. repair of anterior vaginal wall
6. Complications
a. infection
b. urinary incontinence
7. Nursing interventions
a. assessment
i. history of obstetrical trauma, abdominal surgery, menopause, and
estrogen therapy
ii. changes in micturition
iii. pain level
iv. bulge from vagina while standing upright
v. bulge from perineum when patient bears down (illustration )
b. provide pain management as ordered
c. control incontinence
d. prevent urinary retention
2. Pelvic inflammatory disease (PID)
4. Definition - infection of the cervix ascending to the fallopian tubes and broad ligaments
5. Etiology
 a. increased incidence due to reinfection
b. causative agents:
i. neisseria gonorrhoeae
ii. C. trachomatis
iii. mycoplasma hominis
c. history of multiple sexual partners
d. use of IUD's (intrauterine device)
e. history of therapeutic abortion
f. history of caesarean section(s)
6. Findings
a. pelvic pain
b. fever, cervical discharge
c. cervical motion tenderness
d. irregular bleeding
e. nausea, vomiting, acute abdomen
f. dysuria, frequency
g. chlamydia (see STDs on page 30 of this lesson)
7. Diagnostics
a. endocervical culture
b. CBC
c. laparoscopy to view fallopian tubes
8. Management
a. medications (may be used in combination therapy)
i. tetracyclines
ii. penicillins
iii. quinolones
iv. cephalosporins
b. potential surgical intervention to drain abscess
3. Endometriosis (illustration )
4. Definition - endometrium tissue grows in cysts at various sites throughout the pelvis
and/or abdominal wall
5. Etiology
a. occurs at any age; most commonly 25 to 45
b. higher incidence in white women than in African American women
c. responds to ovarian hormonal stimulation
i. progestins decrease it
ii. estrogens increase it
6. Findings
a. may be asymptomatic
b. may be present with pelvic pain
c. dyspareunia
d. painful defecation
e. abnormal uterine bleeding
f. persistent infertility
g. hematuria, dysuria and flank pain if bladder is involved
7. Diagnostics
a. pelvic examination
b. rectal examination
c. laparoscopy
d. ultrasound, CT scan, barium studies
8. Management
a. medical:
i. danazol (Cyclomen) - atrophy of ectopic endometrial tissue
ii. leuprolide acetate (Lupron) - reduction of pain/lesions in
endometriosis
iii. progestins - decreases endometriosis
iv. oral contraceptives
b. surgical:
i. laparoscopic surgery
 ii. CO2 laser laparoscopy
iii. laparotomy
iv. presacral neurectomy
v. hysterectomy (illustration )
9. Complications - infertility
10. Nursing interventions
a. assess
i. history of current signs and symptoms
ii. pain level
iii. impact of infertility (especially in child-bearing age group)
b. reduce pain
c. increase self-esteem
4. Cervical cancer
4. Definition - three types:
a. dysplasia
b. carcinoma in situ
c. invasive carcinoma
5. Etiology/epidemiology
a. 35 to 55 years of age is the most common age group
b. higher incidence in African Americans
c. higher incidence among low socioeconomic populations
d. risk factors include:
i. multiple sexual partners
ii. history of STD's
iii. early sexual activity
6. Findings
a. usually asymptomatic in early stages
b. postcoital bleeding, irregular vaginal bleeding
c. spotting between periods
d. spotting after menopause
e. evidence of discharge
f. pain with radiation to buttocks and legs
g. anemia
h. weight loss
i. fever
7. Diagnostics
a. Papanicolaou test
b. staging laparotomy
c. metastatic evaluation:
i. IVP
ii. cystoscopy
iii. sigmoidoscopy
8. Management
a. radiotherapy
i. used in all stages
ii. internal - radium via applicator
iii. external - via linear accelerator or cobalt
b. surgery
i. hysterectomy (illustration )
1. if childbearing is no longer wanted
2. if carcinoma in situ or invasive carcinoma, combine with
radiotherapy
3. complication: impairment of the bladder not uncommon
ii. pelvic exenteration
iii. conization
c. chemotherapy
i. used as an adjunct with surgery or radiation if indicated
ii. specific agents are dependent on diagnosis and often used in
combination therapy
 9. Complications include metastasis to:
a. lungs
b. mediastinum
c. bones
d. liver, and subsequent spread to rectum and bladder
10. Nursing interventions
a. assessment
i. history of pap smears, sexual history and past STD's
ii. history of current symptoms
iii. client's understanding of the disease
b. reduce anxiety
c. enhance body image
5. Breast cancer (illustration )
4. Types of breast cancer
a. in situ ductal
b. in situ lobular
c. invasive ductal
d. invasive lobular
e. inflammatory
f. Paget's Disease of the nipple
g. tubular
h. medullary
i. mucinous
j. papillary
k. sarcoma
5. Etiology
a. in women, begins in lining of milk duct
b. higher risk if family history
c. risk may increase with use of hormones
6. Findings (illustration )
a. painless firm lump
b. painless thickening in breast
c. enlargement of axillary nodes or supraclavicular nodes
d. nipple discharge
e. scaliness or retraction of nipple (seen more in Paget's Disease)
f. pain, ulceration, edema, orange-peel skin (usually late findings)
7. Diagnostics
a. mammography
b.biopsy or aspiration
c. tumor cell tests
d. lab tests to determine metastases
8. Management
a. surgical approach (will depend on lymph node biopsies and tumor staging):
i. lumpectomy
ii. partial mastectomy
iii. modified radical mastectomy
iv. radical mastectomy
v. simple mastectomy
vi. axillary dissection
b. radiation therapy
c. chemotherapy:
i. cyclophosphamide (Cytoxan)
ii. methotrexate (Mexate)
iii. doxorubicin HCL (Adriamycin)
iv. paclitaxel (Taxol)
d. endocrine therapy
i. bone marrow transplant
ii. oophorectomy
 iii. adrenalectomy
e. hormone therapy
i. use of tamoxifen (Nolvadex)
1. to block the effects of estrogen
2. for post-menopausal women with positive nodes
3. course of treatment a minimum of two years
ii. use of other hormones in advanced disease:
1. estrogens (DES) or ethinyl estradiol (Estinyl) to suppress
FSH and LH
2. progestins may decrease estrogen receptors
3. androgens may suppress FSH and estrogen production
4. aminoglutethimide blocks estrogen by blocking adrenal
steroids
5. corticosteroids suppress secretion estrogen and
progesterone from the adrenal glands
9. Complications of breast cancer
a. metastases
b. bone pain, neurologic changes, weight loss, anemia
c. shortness of breath, cough, pleuritic pain, nonspecific chest discomfort
10. Nursing interventions: assess
a. health history
b. type of education needed
c. level of anxiety and fear
d. coping ability
e. available support systems
i. reduce anxiety
ii. provide education
iii. enhance coping strategies
11. Issues for male patient with breast cancer
a. resembles cancer of the breast in women
b. greater incidence in men in their 60's
c. accounts for 1% of all cases
d. prognosis is poor because men delay seeking treatment
e. gynecomastia can be a contributing factor
2. Genitourinary Disorders
1. Urinary tract infections (UTI)
4. Infections, by various agents, of parts of the urinary system
5. Etiology
a. causative agent enters via urinary meatus
b. women are more susceptible
c. can be caused by poor voiding habits
d. in women, acute infection caused most often by Escherichia coli
e. in men, cause is usually obstructive abnormalities
6. Findings
a. dysuria, frequency, urgency, nocturia
b. suprapubic pain
c. Findings of hematuria
7. Diagnostics
a. urine dipstick
b. urine microscopy
c. urine culture
8. Management
a. antimicrobial therapy as indicated:
b. in uncomplicated infection:
i. co-trimoxazole (Bactrim)
ii. ofloxacin (Floxin)
iii. nitrofurantoin (Macrodantin)
c. in complicated infection:
i. oral antimicrobials as ordered
ii. IV antimicrobials may be indicated
 9. Complications
a. pyelonephritis
b. sepsis
10. Nursing interventions
a. assess:
i. history of urinary tract infections (UTIs)
ii. voiding habits, personal hygiene, contraceptive methods
iii. history of vaginal discharges, itching, irritation, dysuria
b. manage pain:
i. systemic analgesics and
ii. urinary analgesics/antispasmodics
c. client teaching
i. preventive measures
1. in the female client, discuss voiding after intercourse
ii. nutritional considerations
1. increase water intake
2. avoid coffee, tea, alcohol, and colas (carbonated and
noncarbonated)
2. Sexually transmitted diseases (STDs) and genital lesions
4. Definition of STDs: diseases resulting from sexual intercourse with an infected individual
5. Etiologies
a. genital herpes - herpes simplex virus (illustration )
b. syphilis - treponema pallidum (illustration )
c. chancroid - haemophilus ducreyi (illustration )
d. lymphogranuloma venereum (LVG) - sub type of C. trachomatis
e. condyloma acuminatum (genital warts) - subtype of human papillomavirus
(HPV)
6. Findings (see table on page 30 of this lesson)
a. genital herpes: clustered painful vesicles and ulcers, mild lymphadenopathy;
can be reactivated as a result of stress, infection, pregnancy, sunburn
b. syphilis
i. primary type: non-tender, painless, shallow, indurated clean ulcer,
mild regional lymphadenopathy
ii. secondary type: maculopapular rash, mucous patches, fever,
generalized lymphadenopathy (flu-like illness)
iii. chancroid: well circumscribed, painful ulcers with ragged borders,
purulent exudate, tender inguinal nodes in 50% of patients
iv. lvg: small, transient, non-tender papule ulcer which precedes firm,
unilateral inguinal and femoral lymph nodes (buboes) with a
characteristic groove in between
v. condyloma acuminatum: single or multiple soft, fleshy, vegetating
growth(s); may occur on penis
7. Diagnostics (for lab tests, see table on page 30 of this lesson)
a. genital herpes:Tzank smear, viral culture
b. syphilis: VDRL, rapid plasma reagin (RPR)
c. chancroid: gram, gimesa, or Wright stain
d. LGV: microimmunofluorescence testing of aspirate from bubo
e. condyloma acuminatum: Papanicolaou test and/or biopsy
8. Management and pharmacology - common agents in the treatment of STDs (choice
depends on diagnosis):
a. acyclovir sodium (Zovirax)
b. penicillin (Megacillin)
c. doxycycline hyclate (Vibramycin)
d. tetracycline HCL (Achromycin)
e. ceftriaxone sodium (Rocephin)
f. topical therapies:
 i. podofilox (Condylox)
ii. podophylum resin (Podoben)
9. Nursing interventions
a. assess
i. history of current lesions
ii. history of other sexually transmitted diseases
b. reduce fear and anxiety
c. discuss coping with altered body image

C. Renal calculi
1. Definition - presence of stones in the kidneys
2. Etiology
a. causes:
i. hypercalcemia
ii. hypercalciuria
iii. chronic dehydration
iv. high purine diet (organ meats, yeast, etc.)
v. cystinuria (genetic disorder)
vi. chronic infections (proteus vulgaris)
vii. chronic obstruction with urinary stasis
viii. environmental factor: living in a warm, humid climate
b. epidemiology
i. more prevalent in men
ii. can be anywhere in the urinary system
iii. peak age of onset is 20 to 30 years of age
iv. spontaneous passage occurs in 80% of patients
v. calculi can lodge and cause obstruction. Common sites are:
• bladder neck
• renal pelvis
• ureters
vi. often recur in patients with history of two or more stones
3. Findings
a. pain - site dependent on location of obstruction
b. increased hydrostatic pressure
c. renal colic
d. urethral colic
e. findings can mimic cystitis
f. with obstruction: when stones (calculi) block urine flow, client will show
findings of UTI with fever and chills
g. gastrointestinal findings
i. nausea and vomiting
ii. diarrhea
iii. abdominal discomfort
4. Diagnostics
a. IVP to determine site and degree of obstruction
b. retrograde or antegrade pyelography
c. analysis of stone material
d. urinalysis
e. urine culture and sensitivity
5. Management
a. extracorporeal shock wave lithotripsy (ESWL)
b. percutaneous nephrolithotomy (PCNL)
c. percutaneous stone dissolution (Chemolysis)
i. introduce a solvent (depending on the composition of the stone)
ii. give broad-spectrum antimicrobials before, during and after the
procedure to maintain sterile urine
d. ureteroscopy
 e. pyelolithotomy, nephrolithotomy, ureterolithotomy,
f. cystolithotomy
g. nephrectomy (surgical removal of a kidney)
6. Complications
a. obstruction from residual stone material (fragments)
b. infection resulting from bacteria or spread of fragments from infected stone
c. impaired renal function û may be chronic if stones obstructed tubes long before
removal and treatment
7. Nursing interventions
a. assess
i. history of UTI's, dietary habits, and family history of stones
ii. pain and location
iii. for findings of UTI
iv. for findings of obstruction
b. manage pain
c. maintain urine flow
d. control infection
e. client teaching

Client Teaching: Diet To Prevent Kidney Stones

A. Decrease sodium intake

B. Avoid the following:
1. Foods enriched with Vitamin D (Vitamin D increases calcium reabsorption)
2. Dairy: cheeses, milk, sour cream
3. Meat and fowl: brain, heart, liver, kidneys
4. Vegetables: beets, collards, mustard greens, spinach, peas, soybeans, endive, celery
5. Fruits: all berries, currants, figs, Concord grapes
6. Breads: whole grain breads, cereals etc, all breads made with self-rising flower, wheat germ, all
grits
7. Drinks: any made from milk or milk products; draft beer; carbonated drinks
8. Other: chocolate, nuts, peanut butter, all foods made from milk or milk products, such as cakes,
cookies
9. Acute renal failure
A. Definition: kidneys fail to function
B. Etiology
A. causes; pathophysiology
A. prerenal - decreased renal blood flow
B. postrenal - stops or slows urine flow anywhere in the urinary tract
C. intrarenal - injury to renal tissue due to toxins, intrarenal ischemia,
vascular disorders and immunologic processes
B. stages
A. begins when kidney is injured
B. oliguric/anuric phase (less than 500 ml of output in 24hrs)
C. diuretic phase: 24-hr. urine exceeds 500 ml and there is no longer a
rise in serum BUN and creatinine levels
D. recovery phase:
A. several months to one year
B. more likely to leave scar tissue remnants
C. functional loss usually not clinically significant
C. Diagnostics
A. urinalysis
B. serum creatinine and BUN levels rise
C. urine chemistry evaluation to distinguish phase and form
D. renal ultrasonography
D. Management
A. preventive
 A.patient education re: use of analgesics, proper hydration, exposure to
nephrotoxins
B. monitor intake and output
C. avoid infection; if present, use only prescribed medications which
will be specific to patient needs
B. supportive
A. improve renal perfusion
B. monitor intake and output
C. correct and control hyperkalemia
D. maintain adequate blood pressure
E. maintain nutritional intake
F. if indicated, initiate hemodialysis or peritoneal dialysis
E. Complications:
A. infection
B. arrhythmias secondary to hyperkalemia
C. electrolyte imbalances
D. GI bleeding due to stress ulcer
E. multiple organ and system failure
F. Nursing interventions
A. assess:
A. history of cardiac disease, malignancy, sepsis or recent infection
B. exposure to nephrotoxic drugs:
A. NSAIDs
B. antibiotics
C. chemical solvents
D. contrast media
C. urine volume
B. achieve fluid and electrolyte balance
C. prevent infection
D. monitor serum electrolytes
E. prevent GI bleeding
F. maintain neurologic function
G. maintain adequate nutrition:
A. regulate protein intake
B. offer high-carbohydrate feedings
C. weigh daily
D. restrict (as needed) foods high in sodium, potassium and phosphorus
E. give total parenteral nutrition (TPN) if indicated and ordered
10. Chronic renal failure
A. Definition - a progressive, irreversible deterioration in renal function: body cannot
balance metabolism and fluid/electrolytes; result: uremia.
B. Etiologies
A. hypertension, severe and prolonged
B. diabetes mellitus
C. glomerulopathy
D. interstitial nephritis
E. polycystic disease (hereditary)
F. obstructive uropathy
G. congenital disorder
C. Findings of chronic renal failure (by system):
 4. Diagnostics
a. arterial blood gases
b. elevated serum BUN, creatinine, phosphorus
c. CBC to detect anemia
d. decreased serum levels of bicarbonate, calcium, proteins (albumin)
5. Management
a. control diabetes
b. treat hypertension
c. maintain renal function for as long as possible
d. regulate diet:
i. maintain low protein intake
ii. prevent malnutrition
iii. restrict dietary potassium
iv. restrict dietary phosphorus by reducing intake of chicken, milk,
legumes, carbonated drinks
e. treat anemia with epoetin (Erythropoietin)
f. treat acidosis with oral sodium bicarbonate
g. dialysis when necessary
6. Complication: death
7. Nursing interventions
a. assess
i. history of chronic disorders
ii. degree of renal impairment
iii. effect on other body systems
iv. how client is responding to illness
v. support systems
b. maintain fluid and electrolyte balance
c. maintain adequate nutrition
d. maintain skin integrity
e. prevent constipation
f. maintain safe level of activity
g. determine how much client understands and how well client will comply with
treatment
2. After a urinary catheter is removed, the client may have some burning on urination, frequency and dribbling.
These symptoms should subside.
3. After a TUR (transurethral resection), tell the client that, because the three-way foley catheter has a large
diameter, he will continuously feel the urge to void.
 4. After prostatic surgery, it is normal for the client's urine to be blood tinged and for him to pass blood clots
and tissue debris.
5. Because the prostate gland receives a rich blood supply, it is important to observe the client undergoing a
prostatectomy for bleeding and shock.
6. Breast cancer starts with the alteration of a single cell and takes a minimum of two years to become palpable.
7. At the time of diagnosis, about one-half of clients with breast cancer have regional or distant metastasis.

Bacteriuria
Cryptorchidism
Dysmenorrhea
Enuresis
Epididymitis
Incontinence
Lymphedema
Nephrotic Syndrome
Pessary
Polyuria
Prostatitis
Rectocele
Strangury
Stress Incontinence
Toxic shock syndrome
Urge Incontinence
Urgency
Vasectomy

Genitourinary

• Breast cancer Breast self examination Catheterization of urinary bladder Chancre

• Ectopic pregnancy Endometriosis Female genital organs Formation of urine Genital herpes Human ovum
• Hysterectomy Kidney Male genital organs
• Nephron and blood vessels Oogenesis Perinium
• Spermatozoon Syphillis Testis
• Urinary bladder Urinary system Vagina Vas deferens Vulva