The Nuts and Bolts of the
Female Pelvis
Normal Anatomy and Physiology
In women, the urinary tract is composed of four organs. From top to bottom,
these include the kidneys, the ureters, the bladder, and the urethra. The kidneys
sit under the ribs in the back. Isolated from the organs of the abdomen, the
kidneys are covered in fat and muscle. They filter the blood, reabsorbing the
red blood cells and eliminating toxins into the urine. Also producing agents
that help with the metabolism of calcium and the production of red blood
cells, the kidneys are vital structures. Fortunately, most of us have two of them
but we can live normally with only one. If one kidney becomes diseased, it can
be removed without any negative impact, as long as the other one is normal.
When kidneys become inflamed, they cause severe back pain and fever.
Infections of the kidneys start either in the bladder and ascend into the
kidneys, or they begin in the blood and seed the kidneys. Kidney infections
are serious. They cause high fevers and require long-term antibiotics for
eradication. Fortunately, only 1 percent of bladder infections in women
ascend the urinary tract and affect the kidneys. The kidneys are very resilient
organs. In an anatomically normal woman, even a severe kidney infection
will not cause permanent damage.
After filtering the blood, the kidneys eliminate toxins from the body
through tiny tubes called ureters. The ureters are conduits through which
the urine passes on its way into the bladder. If there is a blockage below the
kidneys, the ureters will become dilated and will fill with water. As anyone
who has had a kidney stone can attest to when the ureters become dilated,
it is excruciatingly painful. A blocked ureter will cause severe, colicky back
pain. The most common cause of urethral obstruction is a stone that forms
in the kidney, gets washed into the ureter, and becomes stuck in the smallcaliber
tube.
If the process causing the blockage is slow-growing, the dilation of
the ureter may not be painful. If the ureters are blocked by a prolapsed