Efferent control of different visceral pelvic organs by spinal and supraspinal centres

A growing number of patients with pelvic organ dysfunction and failing response to standard treatment concepts are referred to special neuro-urology services. New therapeutic options are available, such as unilateral and bilateral sacral nerve stimulation, and the use of different neurotoxins for the overactive bladder. However, a lack of knowledge and understanding in central innervation and modulation of pelvic organ function prevents a striking progress in this clinical area. A concept of efferent innervation of pelvic organs based on experimental animal studies, using the retrograde, transneuronal and self-amplifying tracer Pseudorabiesvirus, is discussed in a clinical context.