[Physiology of the urethral sphincteric vesico-prostatic complex].

Area of Science:

• Urology
• Neuroscience
• Anatomy

Context:

• The urethral sphincteric complex is vital for urinary continence.
• Innervation pathways involve complex interactions between the autonomic and somatic nervous systems.
• Understanding these pathways is essential for diagnosing and treating lower urinary tract dysfunction.

Purpose:

• To review and synthesize current literature on the innervation and physiology of the urethral sphincteric complex.
• To clarify the roles of parasympathetic, orthosympathetic, and somatic nervous system components.
• To provide a foundation for understanding the mechanisms of urinary continence.

Summary:

• Parasympathetic innervation originates from sacral nerves (S2-S4).
• Orthosympathetic innervation derives from the superior hypogastric plexus via pelvic plexuses.
• Somatic innervation, primarily from the pudendal nerve (S2-S4), innervates the pelvic floor and rhabdosphincter.
• The bladder neck and smooth muscle sphincter are mainly under orthosympathetic control.
• The rhabdosphincter receives innervation from both the pudendal nerve and pelvic plexus, contributing to tonic urethral compression.
• The levator ani muscle, particularly its pubococcygeal portion, aids in sphincteric tone and stream cessation.

Impact:

• This review enhances understanding of the neuroanatomy and neurophysiology of urinary continence.
• It provides a comprehensive resource for clinicians and researchers investigating lower urinary tract disorders.
• Insights into the complex innervation patterns can inform therapeutic strategies for conditions affecting bladder control.