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Renal and Genitourinary Concerns

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Book cover Principles of Clinical Medicine for Space Flight

Abstract

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, with even higher percentages 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 and immediately pre- and postflight. These stresses may include rigorous exercise, microgravity, dietary changes, limited availability of drinking water, thermal stress, and the effects of other spaceflight-related disorders, such as space motion sickness, as well as the influence of medications used to treat them. Some of these conditions may increase the risk of genitourinary disorders or complicate their presentation. Exposure to microgravity causes a number of metabolic and physiological changes that can affect the GU organs. 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 consequence 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 the diagnosis and management of GU conditions, as immediate return to Earth will not be possible. This chapter reviews the influence of space flight on GU function, the disorders that might arise involving this system, and possible treatment methods and countermeasures.

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Acknowledgments

The authors would like to acknowledge the following individuals for their contributions: Glenn Preminger MD, Duke University; Donald Griffith MD, Tim Boone MD, Michael Coburn MD, Larry Lipshultz MD, Kevin Slawin MD, and Brian Miles MD, Baylor College of Medicine; Y. Charles Pak and Joe Zerwekh and Howard Heller MD, University of Texas Southwestern; James Lingeman MD, Indiana University Medical Center; Clarence Sams PhD, NASA Human Countermeasures Office, and Igor Gontcharov MD, Institute for Biomedical Problems; David Reyes MD, Wyle Science, Technology and Engineering; and James Locke MD, NASA JSC.

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Authors and Affiliations

  1. Scott Department of Urology, Center for Space Medicine, Baylor College of Medicine/Michael E. DeBakey VA Medical Center, Houston, TX, USA

    Jeffrey A. Jones

  2. International Space Station Medical Projects (ISSMP), KBR, Houston, TX, USA

    Robert A. Pietrzyk

  3. Emory Transplant Center, Emory University School of Medicine, Atlanta, GA, USA

    Octav Cristea

  4. NASA Johnson Space Center, Houston, TX, USA

    Peggy A. Whitson

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  1. Jeffrey A. Jones
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Correspondence to Jeffrey A. Jones .

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Editors and Affiliations

  1. NASA Johnson Space Center, Houston, TX, USA

    Michael R. Barratt

  2. Gynecologic Oncology and Reproductive Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA

    Ellen S. Baker

  3. Deceased, Formerly Chief, Medical Sciences Division, NASA Johnson Space Center, Houston, TX, USA

    Sam L. Pool

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Jones, J.A., Pietrzyk, R.A., Cristea, O., Whitson, P.A. (2019). Renal and Genitourinary Concerns. In: Barratt, M., Baker, E., Pool, S. (eds) Principles of Clinical Medicine for Space Flight. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-9889-0_18

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