Influence of the adrenergic nervous system on the lower urinary tract and its clinical implications

The morphology of the adrenergic nervous systems as well as adrenoceptor functions of the human lower urinary tract are outlined and compared to some animal studies. Special emphasis is given to the altered adrenergic innervation and adrenoceptor function after parasympathetic decentralization. Pharmacological treatment affecting adrenoceptors is described in different disturbances of lower urinary tract function and some evidence for adrenergic mechanisms working in intravaginal electrical stimulation is presented. The importance of the sympathetic nervous system for the normal function of the human lower urinary tract is still unclear. Nevertheless, clinical data obtained by treatment with agents influencing this system indicate that the contractory alpha-adrenoceptors of the human urethra can be stimulated or blocked pharmacologically producing significant changes in intraurethral pressure. On the other hand, the relaxatory effect on the human detrusor obtained by stimulation of the beta-adrenoceptors seems to be negligible.