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Continence mechanism in the female
B Klevmark1, S Kulseng-Hanssen
1Surgical Department A, Rikshospitalet, Oslo, Norway.
Scandinavian Journal of Urology and Nephrology. Supplementum
|January 1, 1991
Summary
Bladder control involves both automatic and conscious processes. While automatic reflexes manage continence until the urge to void, conscious inhibition and muscle control can temporarily maintain it.
Area of Science:
- Urology
- Neuroscience
- Physiology
Background:
- Continence relies on a complex interplay of automatic and voluntary physiological mechanisms.
- Understanding these regulatory pathways is crucial for addressing urinary incontinence.
- The micturition reflex involves both central nervous system control and peripheral muscle actions.
Purpose of the Study:
- To elucidate the dual regulatory mechanisms of urinary continence.
- To describe the transition from automatic to conscious control during micturition.
- To outline the physiological steps involved in maintaining continence against the urge to void.
Main Methods:
- This study is a review of physiological mechanisms.
- It synthesizes existing knowledge on the neural and muscular control of the bladder and urethra.
- No new experimental data were generated.
Main Results:
- Urinary continence is maintained by automatic regulation until the sensation of a full bladder arises.
- Conscious inhibition of the micturition reflex is possible initially.
- Voluntary muscle contractions (striated muscles and external compression) can temporarily override the reflex.
Conclusions:
- Continence involves a sophisticated balance between involuntary reflexes and voluntary control.
- The ability to consciously inhibit and maintain continence highlights the role of the somatic nervous system.
- Disruptions at any stage of this process can lead to incontinence.