The Urinary System
The important function of the urinary system is to filter blood and generate urine as a waste by product. The organs of the urinary system consists of kidneys, ureters, renal pelvis and urethra.
Male Urethra
The male urethra spans a length of around 15-20 cm and plays an important role in transporting both urine and semen, which is comprised of spermatozoa and fluids from the sex glands.
The Prostatic Urethra
The prostatic urethra starts as an extension of the bladder neck and traverses the prostate gland. It gets the ejaculatory ducts, which carry spermatozoa from the tests and seminal fluid from the seminal vesicle glands, as well as the prostatic ducts, which possess alkaline fluid. This segment of the urethra is the broadest and most expandable section.
The Membranous Urethra
The membranous urethra traverses the pelvic floor and deep perineal pouch. Surrounded by the external urethral sphincter, it allows voluntary command over urination. This segment of the urethra is called for its narrowness and limited expandability.
Penile (Bulbous) Urethra
The penile (bulbous) urethra traverses the bulb and corpus spongiosum of the penis, culminating at the external urethral orifice, also called the meatus. It receives the bulbourethral glands in its proximal region. As it reaches the glans of the penis, the urethra expands to create the navicular fossa.
The male urethra gets its arterial supply from different arteries:
The prostatic urethra gets blood from the inferior vesical artery. It is a branch of the internal iliac artery that supplies the lower part of the bladder.
The membranous urethra is supplied by the bulbourethral artery. It is a branch of the internal pudendal artery.
The penile urethra is directly supplied by branches of the internal pudendal artery.
The nerve supply to the male urethra comes from the prostatic plexus, which possesses a combination of sympathetic, parasympathetic, and visceral afferent fibres.
The Lymphatic Drainage
The lymphatic drainage pattern varies based on the particular area of the urethra. The prostatic and membranous sections drain into the obturator and internal iliac nodes, whereas the penile urethra drains into the deep and superficial inguinal nodes.
Female Urethra
The urethra in females is relatively short, approximately 4 cm. It starts at the neck of the bladder and passes inferiorly via the perineal membrane and muscular pelvic floor. The urethra opens onto the perineum, in a space between the labia minora, called the vestibule.
Inside the vestibule, the urethral opening is situated in front of the vaginal opening, while it is located around 2-3 cm behind the clitoris. The distal part of the urethra is marked by the presence of two mucous glands called Skene’s glands, which are situated on either of the urethra. These glands are similar to the male prostate.
The Neurovascular Supply
The neurovascular supply to the female urethra consists of the internal pudendal arteries, vaginal arteries, and inferior vesical branches of the vaginal arteries for arterial supply. Venous drainage is provided by corresponding veins.
Regarding nerve supply, the female urethra gets innervation from the pudendal nerve and the vesical plexus . Visceral afferents from the urethra travel via the pelvic splanchnic nerves.
Lymphatic Drainage
Lymphatic drainage of the proximal female urethra is to the internal iliac nodes, whereas the distal urethra drains to the superficial inguinal lymph nodes.
Functions
The main function of the urethra is to help the passage of urine from the bladder out of the body. This process is started by signals from the brain to the bladder to shrink and the sphincter muscle to relax, allowing urine to flow through the urethra.
In males, a similar mechanism is employed during ejaculation, where sperm is transported via the urethra. Different from urination, ejaculation involves coordination between nerves in the spinal cord, vas deferns, seminal vesicles, and prostate to close off the bladder opening and propel semel along the penis and via the urethra.
Related Conditions
Urethra cancer
Urethritis: Inflammation of the urethra caused by infection
Urethral strictures: A narrowing of the urethra tube
Urethral diverticulum: A pocket that forms in the urethra and can fill with urine, resulting in pain or difficulty urinating.
Urethritis is a comprehensive and inclusive condition, different from a UTI. Urethritis occurs when bacteria like chlamydia or gonorrhea result in inflammation and discomfort in the urethra. Conversely, UTIs result in infections within the entire urinary tract, which can be created by multiple factors including urethral defects.
Urethral pain can stem from skin conditions, bacteria, medications or diet. Gender-specific causes, like benign prostate hyperplasia in men and epididymitis, can also contribute to this discomfort.
Women can suffer urethral pain because of products such as soaps, spermicides, lotions and douches, in addition to intercourse, bacterial vaginosis and yeast infections. Even menopause can result in a prolapsed urethra in severe cases.
It is vital to discuss any discomfort or pain in your urethra or urinary tract with your doctor. They can analyse your age, overall health and lifestyle factors.
Tests
If there is a suspicion of a urethral disorder, your doctor may request the following tests:
Urine tests: These tests contain an analysis of your urine in a laboratory setting
X-rays and/or ultrasounds: These imaging tests enable your doctor to visualise your bones and soft tissue. Ultrasound can particularly help in assessing your kidneys and bladder.
Cystoscopy: This procedure allows your doctor to examine your urethra and bladder using a cystoscope, which is a small camera-equipped scope.
Retrograde urethrography: This test combines the use of an X-ray with a contrast agent to get detailed images.
Voiding cystourethrogram: This test also employs a contrast agent to observe the bladder’s behaviour during filling and voiding.
Treatments
Various treatments are available for disorders of the urethra, based on the particular disorder. The common treatments include:
Medications: If the disorder is caused by an infection, anti-effective medications like antibiotics can be prescribed. In the case of urethral cancer, chemotherapeutic drugs can be suggested by your doctor.
Procedures: Multiple urethral conditions may need specific treatments. These treatments can include:
– Urethrotomy: With the help of cystoscopy and a cutting instrument, your doctor will eliminate the ring of scar tissue.
– Dilation: Your doctor will attempt to expand the urethra using cystoscopy and instruments such as a balloon.
– Urethroplasty: Tissue from another part of your body will be used by your doctor to build or reconstruct a new urethra.
– Radiation therapy: This treatment involves the use of targeted radiation to destroy cancer cells or shrink tumours.
– Surgery: In a few cases, surgery may be needed to eliminate tumours in the urethra.
It is crucial to consult with a doctor to determine the most appropriate treatment for your specific urethral disorder.
Tips To Keep Your Urethra Healthy
One of the most important things you can do is drink enough fluids, preferably water. Other tips include:
Refrain from smoking or consuming tobacco products
Involve in regular physical activity
Lower your intake of caffeine and alcohol
Aim to achieve and maintain a healthy weight
Prevent constipation
Avoid delaying urination
Use the restroom when needed
Ensure complete emptying of your bladder
Urinate after sexual intercourse
Opt for cotton underwear
Avoid wearing tight pants
Analyse your medications, foods and choice of birth control with your doctor if you have problems with your urinary tract. Some medications and foods can impact your urinary system.
Summary
Your urethra serves as a hollow conduit through which urine, a byproduct of waste, is expelled from your body. Although maintaining its health is not completely within your control, there are measures you can take to promote its well-being.
FAQs
1. What are the two types of urethra?
The urethra is divided into two parts: the anterior urethra and the posterior urethra. The spongy urethra can be further categorised into fossa navicularis, pendulous urethra, and bulbous urethra. Also, the bladder neck, also called as the preprostatic urethra, is considered a distinct part of the urethra.
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The Information including but not limited to text, graphics, images and other material contained on this blog are intended for education and awareness only. No material on this blog is intended to be a substitute for professional medical help including diagnosis or treatment. It is always advisable to consult medical professional before relying on the content. Neither the Author nor Star Health and Allied Insurance Co. Ltd accepts any responsibility for any potential risk to any visitor/reader.