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Control of urinary drainage and voiding.

Warren G Hill1

  • 1Laboratory of Voiding Dysfunction, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts whill@bidmc.harvard.edu.

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Summary

The urinary tract efficiently stores and expels urine despite its composition. Urothelial defects may cause lower urinary tract symptoms like incontinence and pain.

Keywords:
calciumcell and transport physiologycell signalingepithelialurinary tract

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Area of Science:

  • Urology
  • Physiology
  • Anatomy

Background:

  • Urine composition differs significantly from plasma, containing waste products.
  • The urinary tract comprises muscular compartments and sphincters for urine storage and expulsion.
  • The bladder withstands mechanical stress and osmotic gradients while maintaining impermeability.

Purpose of the Study:

  • To describe the physiological and anatomical mechanisms of urine transport, storage, and release.
  • To discuss clinical examples of urinary tract dysfunction.
  • To highlight new findings on urothelial defects in lower urinary tract symptoms.

Main Methods:

  • Review of physiological and anatomical mechanisms.
  • Discussion of clinical examples and recent research findings.

Main Results:

  • The urinary tract coordinates urine movement and storage through neural input and muscular action.
  • The bladder's urothelium provides a protective, impermeable barrier.
  • Lower urinary tract symptoms may stem from urothelial barrier defects or aberrant signaling.

Conclusions:

  • Understanding urinary tract physiology is crucial for diagnosing and treating dysfunction.
  • Urothelial integrity and signaling are key to normal bladder function.
  • Defects in the urothelium are implicated in conditions such as incontinence and urgency.