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Related Experiment Videos

A neurologic basis for the overactive bladder

W C de Groat1

  • 1Department of Pharmacology, University of Pittsburgh School of Medicine, Pennsylvania 15261, USA.

Urology
|January 14, 1998
PubMed
Summary

Disruptions in the brain and spinal cord

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Area of Science:

  • Neuroscience
  • Urology

Background:

  • Lower urinary tract (LUT) function relies on neural circuits in the brain and spinal cord.
  • Disrupted neural control can cause bladder overactivity and incontinence.

Purpose of the Study:

  • Review the central neural control of micturition.
  • Identify mechanisms of neurogenic overactive bladder due to neural injury.

Main Methods:

  • Neuroanatomic, electrophysiologic, and pharmacologic techniques.
  • Experimental models of neural injury (spinal cord transection, brain lesions).

Main Results:

  • Normal urine storage involves spinal reflexes and brain-mediated inhibition.
  • Voiding is controlled by a spinobulbospinal reflex pathway.
  • Brain damage reduces inhibition, causing overactivity; spinal cord damage activates primitive reflexes.

Conclusions:

  • Central nervous control of the LUT involves on-off switching circuits.
  • Damage to inhibitory pathways or bladder afferent sensitization can lead to overactive bladder.

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