Genitourinary (GU) disorders are pervasive in the adult population and broadly include the diagnoses of 15–20% of patients who are discharged from hospitals in the United States. The percentage is higher for ambulatory visits. Along with susceptibility to the common disorders of the general population, the GU system of astronauts is additionally vulnerable to spaceflight- related stresses, both in flight as well as immediately preflight and postflight. These stresses may include rigorous exercise, microgravity, dietary changes, limited availability of drinking water, thermal stress, effects of other spaceflightrelated disorders such as space motion sickness, and influence of medications used to treat other spaceflight-related disorders. Some of these conditions may increase the risk of occurrence of genitourinary disorders or complicate their presentation.
Exposure to microgravity causes a number of metabolic and physiological changes. Fluid volume, electrolyte levels, and bone and muscle undergo changes as the human body adapts to weightlessness. Changes in urinary chemical composition occurring as a part of this adaptation process may lead to the potentially serious consequences of renal stone formation. With the length of human exposure to microgravity extending as we maintain a permanent presence on the International Space Station (ISS), the probability of GU-related illnesses such as renal stones or infections will undoubtedly increase. Exploration-class lunar missions for long-duration settlement and missions to Mars will pose even greater challenges for GU diagnosis and management as immediate return to Earth will not be possible. This chapter reviews spaceflight influences on GU function and disorders that might arise involving this system and describes treatment methods and countermeasures.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Reschke MF, Harm DL, Parker DE, et al. Neurophysiologic aspects: Space motion sickness. In: Nicogossian AE, Huntoon CS, Pool SL (eds.), Space Physiology and Medicine 3rd edn. Philadelphia, PA: Lea and Febiger, Inc.; 1994, pp. 228-260.
Huntoon Charles JB, Bungo MW, Fortner GW. Cardiopulmonary function. In: Nicogossian AE, Huntoon CS, Pool SL (eds.), Space Physiology and Medicine. 3rd edn. Philadelphia, PA: Lea and Febiger, Inc.; 1994, pp. 286-304.
Huntoon CS, Cintron NM, Whitson PA. Endocrine and biochem-ical function. In: Nicogossian AE, Huntoon CS, Pool SL (eds.), Space Physiology and Medicine. 3rd edn. Philadelphia, PA: Lea and Febiger, Inc.; 1994, pp. 334-350.
Morukov B, et al. 120-day head-down tilted bed rest study with participation of female subjects: Tasks and protocols of the studies. Aviakosm Ekolog Med 1997; 31(1):40-47.
Zaichik Y, Morukov B. In vivo bone mineral studies on volun-teers during a 370-day antiorthostatic hypokinesia test. Appl Radiat Isot 1998; 49(5-6):691-694.
Morukov B, et al. Changes in calcium metabolism and its regula-tion in humans during prolonged spaceflight. Fiziol Cheloveka 1998; 24(2):102-107.
Smith M, et al. Bone Mineral measurement experiment M078. In: Johnson RS, Dietlein LF (eds.), Biomedical Results from Sky-lab. Washington, DC NASA SP-377; 1997, pp. 183-190.
Leblanc A, Shackleford L, Schneider V. Future human bone research in space. Bone 1998; 22(5 Suppl.):113S-116S.
Leach CS, Rambaut PC. Biomedical responses of the Skylab crewmen: An overview. In: Johnson RS, Dietlein LF (eds.), Bio-medical Results from Skylab. Washington, DC NASA SP-377; 1997, 204-216.
Smith SM, Wastney ME, Morukov BV, et al. Calcium metabo-lism before, during, and after a 3-month space flight: Kinetic and biochemical changes. Am J Physiol 1999; 277:R1-R10.
Salem ME, Eknoyan G. The kidney in ancient Egyptian medi-cine: Where does it stand? Am J Nephrol 1999; 19(2):140-147.
Manthey DE, Teichman J. Nephrolithiasis. Emerg Med Clin North Am 2001 Aug.; 19(3):633-654, viii.
Hwang TI, Hill K, Schneider V, Pak CY. Effect of prolonged bed rest on the propensity for renal stone formation. J Clin Endocri-nol Metab 1988 Jan.; 66(1):109--112.
Muller CE, Bianchetti M, Kaiser G. Immobilization, a risk factor for urinary tract stones in children. A case report. Eur J Pediatr Surg. 1994 Aug.; 4(4):201-204.
Pak CYC. Medical treatment of renal stone disease. Nephron 1999; 81(Suppl. 1):60-65.
Lingeman JE, Preminger GM. New treatment options for kidney stones. Fam Urol May 2001; 6(2):4-6.
Rivers K, et al. When and how to evaluate a patient with nephro-lithiasis. Urol Clin North Am 2000; 27(2):203-213.
Pak CY, Peterson R, Poindexter JR. Adequacy of a single stone risk analysis in the medical evaluation of urolithiasis. J Urol 2001 Feb.; 165(2):378-381.
Pak CYC. Medical prevention of renal stone disease. Nephron 1991; 81(Suppl. 1):60-65.
Batinic D, et al. Value of the urinary stone promoters/inhibitors ratios in the estimation of the risk of urolithiasis. J Chem Inf Comput Sci 2000 May-Jun.; 40(3):607-610.
Whitson PA, Pietrzyk RA, Pak CYC, Cintron NM. Alterations in renal stone risk factors after spaceflight. J Urol 1993; 150:1-5.
Whitson PA, Pietrzyk RA, Pak CYC. Renal stone risk assessment during space shuttle flights. J Urol 1997; 158: 2305-2310.
Whalley NA, Meyers MN, Margolius LP. Long-term effects of potassium citrate therapy on the formation of new stones in groups of recurrent stone formers with hypocitraturia. Br J Urol 1996; 78(1):10-14.
Sakhaee K, Alpern R, Jacobson HR, Pak CYC. Contrasting effects of various potassium salts on renal citrate excretion. J Clin Endocrinol Metab 1991; 72(2):396-400.
Pak CYC, Fuller CF. Idiopathic hypocitrauric calcium-oxa-late nephrolithiasis successfully treated with potassium citrate. Annals of Int Med 1996; 104:33-37.
Pak CYC. Citrate and renal calculi: An update. Miner Electrolyte Metab 1994; 20(6):371-377.
Grases F, et al. Chronopharmacological studies on potassium citrate treatment of oxalocalcic urolithiasis. Int Urol Nephrol 1997; 29(3):263-273.
Pak CY. Southwestern Internal Medicine Conference: Medical management of nephrolithiasis—a new, simplified approach for general practice. Am J Med Sci 1997; 313(4):215-219.
Pak CYC, Skurla C, Harvey J. Graphic display of urinary risk fac-tors for renal stone formation. J Urol 1985; 134: 867-870.
Ryall RL, Marshall VR. The value of the 24-hour urine analysis in the assessment of stone-formers attending a general outpatient clinic. Br J Urol 1983; 55:1-5.
Yagisawa T, et al. Metabolic risk factors in patients with first-time and recurrent stone formations as determined by compre-hensive metabolic evaluation. Urology 1998; 52(5): 750-755.
Lifshitz DA, et al. Metabolic evaluation of stone disease patients: A practical approach. J Endourol 1999; 13(9):669-678.
Vashi AR, Oesterling JE. Percent free prostate-specific antigen: Entering a new era in the detection of prostate cancer. Mayo Clin Proc 1997; 72:337-344.
Overmyer M. Free PSA test granted FDA approval. Urology Times 1998; 26(4):498-501.
Jones JA, Johnston S, Campbell M, Billica R. Endoscopic surgery and telemedicine in microgravity, developing contingency procedures for exploratory class space flight. Urology 1999; 53(5):892-897.
Selected Readings
Gillenwater J, Grayhack J, Howards S, Duckett J. (eds.), Adult and Pediatric Urology. 2nd edn. St. Louis, MO: Mosby Yearbook; 1991.
Hanno P, Wein A. (eds.), A Clinical Manual of Urology. Norwalk, CT: Appleton-Century-Crofts; 1987. J.A. Jones et al.
Hesse A, Tiselius H-G, Jahnen A. (eds.), Urinary Stones: Diagnosis, Treatment and the Prevention of Recurrence. Basil: Karger; 1994.
Lingeman J, et al. Urinary Calculi ESWL, Endourology, and Medical Therapy. Philadelphia, PA: Lea and Febiger, Inc.; 1989.
Walsh P, Gittes R, Perlmutter A, Stamey T. (eds.), Campbell’s Urology. 5th edn. Philadelphia, PA: W.B. Saunders Co.; 1986.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Jones, J.A., Pietrzyk, R.A., Whitson, P.A. (2008). Renal and Genitourinary Concerns. In: Barratt, M.R., Pool, S.L. (eds) Principles of Clinical Medicine for Space Flight. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68164-1_13
Download citation
DOI: https://doi.org/10.1007/978-0-387-68164-1_13
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-98842-9
Online ISBN: 978-0-387-68164-1
eBook Packages: MedicineMedicine (R0)