Brainstem neurons coordinate the bladder and urethral sphincter for urination
Xing Li1, Xianping Li2,3, Jun Li1
1Advanced Institute for Brain and Intelligence, School of Physical Science and Technology, Guangxi University, Nanning, China.
Elife
|August 6, 2026
Summary
Scientists identified estrogen receptor 1-positive (ESR1+) neurons in the brainstem
Area of Science:
- Neuroscience
- Urology
- Endocrinology
Background:
- Urination requires coordinated bladder and external urethral sphincter (EUS) function, controlled by a complex neural network.
- Specific neuronal populations responsible for this coordination are unidentified, hindering therapies for disorders like detrusor-sphincter dyssynergia.
Purpose of the Study:
- To identify the specific neuronal subpopulations in the pontine micturition center (PMC) that control bladder-EUS coordination.
- To elucidate the role of estrogen receptor 1-positive (ESR1+) neurons in regulating the micturition process.
Main Methods:
- Investigated the function of PMC ESR1+ neurons in controlling urination.
- Utilized nerve transection experiments (pelvic and pudendal nerves) to determine neuronal pathways.
- Anatomically traced spinal projections of PMC ESR1+ neurons.
Main Results:
- Activation of PMC ESR1+ neurons reliably initiated voiding, while suppression halted it.
- PMC ESR1+ neurons control the EUS via the pudendal nerve and the bladder via the pelvic nerve, independent of each other's pathways.
- Identified three distinct subpopulations of PMC ESR1+ neurons projecting to the sacral parasympathetic nucleus and/or dorsal gray commissure.
Conclusions:
- Estrogen receptor 1-positive (ESR1+) neurons in the pontine micturition center (PMC) are critical for coordinating bladder contraction and EUS relaxation.
- These neurons represent a key cell type in the brainstem controlling the precise temporal sequence required for urination.
- Discovery offers potential therapeutic targets for urination disorders involving bladder-sphincter dyssynergia.
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