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Rad
ANATOMY
Genitourinary System
• Urinary System
– Kidney
– Ureter
– Bladder
– Urethra
ANATOMY
ANATOMY
Genitourinary System
• Genital/Reproductive
– Male – Female
• Testis • Uterus
• Epidydimis • Salphynx
• Vas deferen • Ovaries
• Ejaculatory duct • Cervix
• Prostate • Vagina
• Seminal vesicle
• Penis
ANATOMY
Male Reproductive System
ANATOMY
Female Reproductive System
ANATOMY
KIDNEY
• Bean shaped (convex laterally & concave medially)
• Length: ±11,5cm or 31/2 vertebral body)
• Width: ±5-8cm
• Thickness: ±3cm
• Retroperitoneal
• Between Th12- L3
• Right kidney is lower ± 1cm than left kidney
ANATOMY
KIDNEY
ANATOMY
KIDNEY
ANATOMY
URETER
• Diameter 1mm-1cm
• Length: 25-30cm
• Retroperitoneal
• Three normal narrowing area
– Pelvoureter junction (PUJ)
– Pelvic brim where the iliac vessels cross the ureter
– Vesicoureter junction (VUJ)
ANATOMY
URETER
ANATOMY
BLADDER
• Urine reservoir
• Posterosuperior to the pubic bone
• Position:
– Empty: In the pelvic cavity
– Full: Extend to the abdominal cavity
• Capacity
– Adult: 350-500 cc
– Children: (Age [in year] + 2) x 30 cc
ANATOMY
BLADDER
ANATOMY
URETHRA
• Length:
– Male: 17,5-20cm
– Female: 4cm
• Male urethra divided by inferior aspect of urogenital
diaphragm into:
– Anterior part
• Cavernous/Penile part
• Bulbar part
– Posterior part
• Membranous part
• Prostatic part
ANATOMY
URETHRA
ANATOMY
IMAGING MODALITIES
– Plain abdominal x ray
– BNO-IVP
– Retrograde
uretrography/cystography/urethrocystography
– Bipolar Urethrocystography
– Voiding Cystourethrography
– Ultrasonography
– CT Scan
– MRI
– Nuclear Imaging
– Hysterosalphingography
PLAIN ABDOMINAL X-RAY
• Routine
• Good quality films will show the kidney outlines
– Enlargement (mass/hydronephrosis) can be
recognized
• Calcification
– Opaque calculi in the kidney, ureter or bladder
– Nephrocalcinosis : calcification in the renal
parenchym.
• Air distribution in the bowel
– Sentinel loop
NORMAL
KIDNEY STONE
KIDNEY STONE
URETERAL STONE
BLADDER STONE
IMAGING MODALITIES
– Plain abdominal x ray
– BNO-IVP
– Retrograde
uretrography/cystography/urethrocystography
– Bipolar Urethrocystography
– Voiding Cystourethrography
– Ultrasonography
– CT Scan
– MRI
– Nuclear Imaging
– Hysterosalphingography
BNO-IVP
• Blass = Urinary bladder, Nier = Kidney,
Overzicht = Examination
• Synonim:
– Intravenous urography
– Excretory urography
– Intravenous pyelography
BNO-IVP
• Use contrast media intravenously
• Anatomic function:
– Depict the minor calyx, major calyx, renal pelvis,
ureter, urinary bladder.
• Physiologic function:
– Assess the kidney function in contrast media
filtration and excretion.
BNO-IVP
• Indication
– Evaluate mass or cyst
– Urolithiasis (calculi in the kidney or urinary tract)
– Pyelonephritis
– Glomerulonephritis
– Hydronephrosis
– Trauma
– Renal hypertension
BNO-IVP
• Contraindication
– Allergy
– Asthma
– Anuria
– Renal failure
– Cardiovascular disease
– Severe liver function abnormality
– Diabetes mellitus
– Sickle cell disease
– Multiple myeloma
– Pheochromocytoma
– Pregnancy
BNO-IVP
• Contraindication
– Allergy
– Asthma
– Anuria
– Renal failure
– Cardiovascular disease
– Severe liver function abnormality
– Diabetes mellitus
– Sickle cell disease
– Multiple myeloma
– Pheochromocytoma
– Pregnancy
BNO-IVP
Procedure
• 1-3minute : Nephrogram phase
• Ureteral compression
• 5 minute : Excretory function
• 15 minute : Pelvocalyceal system
• Compression can be released if the pelvocalyceal system has
been seen adequately
• 30 minute : After the compression was released to
see the urinary tract from the kidney
to the bladder
• 45-60 minute : fullbladder
• Post voiding : passage of contrast agent
BNO-IVP
Contraindication of compression :
• Suspected stone
• Acute abdomen
• Following abdominal surgery
• Large abdominal mass
• Aortic aneurysm
Renal mass
IMAGING MODALITIES
– Plain abdominal x ray
– BNO-IVP
– Retrograde & antegrade pyelography
– Retrograde
uretrography/cystography/urethrocystography
– Bipolar Urethrocystography
– Ultrasonography
– CT Scan
– MRI
– Hysterosalphingography
Hysterosalpingography
• Primarily demonstrate the uterus and the
salpynx (fallopian tube)
Hysterosalpingography
Indication
• Infertility assessment
– Obstruction (can be therapeutic)
– Anatomic anomaly (e.g.uterine bicornis)
• Intrauterine pathology
– Endometrial polyps
– Uterine fibroids
– Intrauterine adhesion
• Post operative assessment after tubal ligation or
reconstructive surgery
Hysterosalpingography
Contraindication
• Pregnancy (performed 7-10 days after the
onset of menstruation)
• Acute pelvic inflammatory disease
• Active uterine bleeding
Hysterosalpingography
Left Hydrosalpynx
Uterus bicornis
Thank you for your attention