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Neuroanatomy and Neurophysiology

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Female Genitourinary and Pelvic Floor Reconstruction

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Abstract

The bladder has only two simple tasks, to store and empty urine. However, the regulation of these tasks requires strong coordination of afferent and communication between the bladder and the brain, known as the spino-bulbo-spinal reflex arc. As more urine is stored in the bladder, the urothelium is stretched, and afferent neurons are activated. For urinary storage and emptying, information is carried through the pelvic and pundendal nerves to the sacral spinal cord and then to the periaqueductal gray region in the midbrain. Input from the cortex initially shifts the bladder to storage. The sympathetic nervous system is stimulated through the hypogastric nerve, and the detrusor muscle relaxes and the bladder outlet tightens to facilitate storage of urine and avoid leakage per urethra. Once a volume threshold is met, the periaqueductal gray region releases inhibition of the pontine micturition complex. Bladder voiding is now initiated by parasympathetic stimulation of the detrusor through the pelvic nerves. Coordination between this change between storage and voiding can be disrupted by neurologic diseases or injuries to the central or peripheral nervous system.

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Authors and Affiliations

  1. University of Michigan, Ann Arbor, MI, USA

    John T. Stoffel

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  1. John T. Stoffel
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Correspondence to John T. Stoffel .

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  1. University of Lisbon, Lisbon, Portugal

    Francisco E. Martins

  2. University of Oslo, Oslo, Norway

    Henriette Veiby Holm

  3. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jaspreet Sandhu

  4. Eastern Virginia Medical School, Norfolk, VA, USA

    Kurt A McCammon

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Stoffel, J.T. (2022). Neuroanatomy and Neurophysiology. In: Martins, F.E., Holm, H.V., Sandhu, J., McCammon, K.A. (eds) Female Genitourinary and Pelvic Floor Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-71112-2_3-1

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  • DOI: https://doi.org/10.1007/978-3-030-71112-2_3-1

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  • Print ISBN: 978-3-030-71112-2

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