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Neurourology and pelvic floor dysfunction.

H Madersbacher1

  • 1Neuro-Urology Unit, Department of Neurology, Landeskrankenhaus, University-Hospital Innsbruck, Innsbruck, Austria. helmut.madersbacher@tilak.at

Minerva Ginecologica
|September 21, 2004
PubMed
Summary
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The pelvic floor musculature (PFM) system involves complex neural control for bladder function. Understanding these reflexes is key to treating overactive bladder conditions.

Area of Science:

  • Neuroscience
  • Urology
  • Pelvic Floor Physiology

Background:

  • The pelvic floor musculature (PFM), including levator ani muscles and endopelvic fascia, functions as an integrated system.
  • Normal PFM function relies on physiological organization of Onuf's nuclei, levator ani motorneurons, and reflex control for sustained muscle activity.

Purpose of the Study:

  • To elucidate the neural control mechanisms governing the pelvic floor musculature (PFM) and their role in lower urinary tract function.
  • To explore the brain's involvement in voluntary and emotional control of the PFM, including micturition.

Main Methods:

  • Review of neurophysiological principles governing PFM function.
  • Analysis of reflex pathways coordinating the urinary bladder, urethra, and PFM.
  • Examination of central nervous system and peripheral nerve influences on PFM control.

Related Experiment Videos

Main Results:

  • The motor cortex plays a vital role in voluntary PFM control, with other brain regions involved in emotionally related activities like micturition.
  • Complex reflex pathways in the brain and spinal cord mediate coordination between the bladder, urethra, and PFM for urine storage and voiding.
  • Potential for serial linking of reflexes to create intricate feedback mechanisms.

Conclusions:

  • Understanding the neural control of striated muscle is crucial for addressing neurological lesions affecting the lower urinary tract.
  • Research findings are relevant to neurogenic and idiopathic overactive bladder, regardless of the lesion's origin (central or peripheral).