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Neural Mechanisms Underlying Lower Urinary Tract Dysfunction

This article summarizes anatomical, neurophysiological, and pharmacological studies in humans and animals to provide insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract and alterations in these mechanisms in lower urinary tract dysfunction. The func...

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Autores principales: Yoshimura, Naoki, Ogawa, Teruyuki, Miyazato, Minoru, Kitta, Takeya, Furuta, Akira, Chancellor, Michael B., Tyagi, Pradeep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Urological Association 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935075/
https://www.ncbi.nlm.nih.gov/pubmed/24578802
http://dx.doi.org/10.4111/kju.2014.55.2.81
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author Yoshimura, Naoki
Ogawa, Teruyuki
Miyazato, Minoru
Kitta, Takeya
Furuta, Akira
Chancellor, Michael B.
Tyagi, Pradeep
author_facet Yoshimura, Naoki
Ogawa, Teruyuki
Miyazato, Minoru
Kitta, Takeya
Furuta, Akira
Chancellor, Michael B.
Tyagi, Pradeep
author_sort Yoshimura, Naoki
collection PubMed
description This article summarizes anatomical, neurophysiological, and pharmacological studies in humans and animals to provide insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract and alterations in these mechanisms in lower urinary tract dysfunction. The functions of the lower urinary tract, to store and periodically release urine, are dependent on the activity of smooth and striated muscles in the bladder, urethra, and external urethral sphincter. During urine storage, the outlet is closed and the bladder smooth muscle is quiescent. When bladder volume reaches the micturition threshold, activation of a micturition center in the dorsolateral pons (the pontine micturition center) induces a bladder contraction and a reciprocal relaxation of the urethra, leading to bladder emptying. During voiding, sacral parasympathetic (pelvic) nerves provide an excitatory input (cholinergic and purinergic) to the bladder and inhibitory input (nitrergic) to the urethra. These peripheral systems are integrated by excitatory and inhibitory regulation at the levels of the spinal cord and the brain. Therefore, injury or diseases of the nervous system, as well as disorders of the peripheral organs, can produce lower urinary tract dysfunction, leading to lower urinary tract symptoms, including both storage and voiding symptoms, and pelvic pain. Neuroplasticity underlying pathological changes in lower urinary tract function is discussed.
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spelling pubmed-39350752014-02-27 Neural Mechanisms Underlying Lower Urinary Tract Dysfunction Yoshimura, Naoki Ogawa, Teruyuki Miyazato, Minoru Kitta, Takeya Furuta, Akira Chancellor, Michael B. Tyagi, Pradeep Korean J Urol Review Article This article summarizes anatomical, neurophysiological, and pharmacological studies in humans and animals to provide insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract and alterations in these mechanisms in lower urinary tract dysfunction. The functions of the lower urinary tract, to store and periodically release urine, are dependent on the activity of smooth and striated muscles in the bladder, urethra, and external urethral sphincter. During urine storage, the outlet is closed and the bladder smooth muscle is quiescent. When bladder volume reaches the micturition threshold, activation of a micturition center in the dorsolateral pons (the pontine micturition center) induces a bladder contraction and a reciprocal relaxation of the urethra, leading to bladder emptying. During voiding, sacral parasympathetic (pelvic) nerves provide an excitatory input (cholinergic and purinergic) to the bladder and inhibitory input (nitrergic) to the urethra. These peripheral systems are integrated by excitatory and inhibitory regulation at the levels of the spinal cord and the brain. Therefore, injury or diseases of the nervous system, as well as disorders of the peripheral organs, can produce lower urinary tract dysfunction, leading to lower urinary tract symptoms, including both storage and voiding symptoms, and pelvic pain. Neuroplasticity underlying pathological changes in lower urinary tract function is discussed. The Korean Urological Association 2014-02 2014-02-14 /pmc/articles/PMC3935075/ /pubmed/24578802 http://dx.doi.org/10.4111/kju.2014.55.2.81 Text en © The Korean Urological Association, 2014 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Yoshimura, Naoki
Ogawa, Teruyuki
Miyazato, Minoru
Kitta, Takeya
Furuta, Akira
Chancellor, Michael B.
Tyagi, Pradeep
Neural Mechanisms Underlying Lower Urinary Tract Dysfunction
title Neural Mechanisms Underlying Lower Urinary Tract Dysfunction
title_full Neural Mechanisms Underlying Lower Urinary Tract Dysfunction
title_fullStr Neural Mechanisms Underlying Lower Urinary Tract Dysfunction
title_full_unstemmed Neural Mechanisms Underlying Lower Urinary Tract Dysfunction
title_short Neural Mechanisms Underlying Lower Urinary Tract Dysfunction
title_sort neural mechanisms underlying lower urinary tract dysfunction
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935075/
https://www.ncbi.nlm.nih.gov/pubmed/24578802
http://dx.doi.org/10.4111/kju.2014.55.2.81
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