International Urogynecology Journal

, Volume 8, Issue 2, pp 85–97

Neurophysiology of micturition and continence in women

  • T. C. Chai
  • W. D. Steers
Review Article

Abstract

Micturition and continence involve the coordination of complex neural events between the central and peripheral nervous systems. An understanding of these events provides a foundation for the treatment of voiding disorders in women such as stress urinary incontinence, urge incontinence and interstitial cystitis. The purpose of this paper is to comprehensively review the neuroanatomy, enurophysiology and neuropharmacology of micturition and continence. However, a brief section discussing clinical correlations will follow each of these topics to help integrate the basic science with clinical obervations.

Keywords

Continence Females Micturition Neuroanatomy Neuropharmacology Neurophysiology 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Laruelle L. La structure de la moelle épinière en coupes longitudinales.Rev Neurol 1937;67:695–725Google Scholar
  2. 2.
    Laruelle L. Etude d’anatomie microscopique du névraxe sur coupes longitudinales.Acta Neurol Psychiatr Belg 1948;48:138–280Google Scholar
  3. 3.
    Mitchell GAG. Anatomy of the autonomic nervous system. Edinburgh: Livingstone, 1953;257–310Google Scholar
  4. 4.
    de Groat WC, Booth AM. Inhibition and facilitation in parasympathetic ganglia of the urinary bladder.Fed Proc 1980;39:2990–2996PubMedGoogle Scholar
  5. 5.
    de Groat WC, Kawatani M. Reorganization of sympathetic preganglionic connections in the cat bladder ganglia following parasympathetic denervation.J Physiol (London) 1989;409:431–449Google Scholar
  6. 6.
    de Groat WC, Lalley PM. Reflex firing in lumbar sympathetic outflow to activation of visceral afferent fibers.J Physiol (London) 1972;226:289–309Google Scholar
  7. 7.
    de Groat WC, Saum WR. Sympathetic inhibition of the urinary bladder and of pelvic ganglionic transmission in the cat.J Physiol (London) 1972;220:297–314Google Scholar
  8. 8.
    Onuf (Onufrowicz) B. Notes on the arrangement and function of the cell groups in the sacral region of the spinal cord.J Nerv Ment Dis 1899;26:498–504Google Scholar
  9. 9.
    Donker PJ, Droes JThPM, Ulden BM. Anatomy of the musculature and innervation of the bladder and the urethra. In: Williams DI, Chisholm GD, eds. Scientific foundations of urology, Vol II. London: Heinemann, 1978;32–39Google Scholar
  10. 10.
    Gosling JA. The structure of the bladder and urethra in relation to function.Urol Clin North Am 1979;6:31–38PubMedGoogle Scholar
  11. 11.
    McGuire EJ, Herlihy E. Bladder and urethral responses to isolated sacral motor root stimulation.Invest Urol 1978;16:219–223PubMedGoogle Scholar
  12. 12.
    Torrens MJ. Urethral sphincteric responses to stimulation of the sacral nerves in the human female.Urol Int 1978;33:22–26Google Scholar
  13. 13.
    Elbadawi A. Neuromorphological basis of vesicourethral function. I. Histochemistry, ultrastructure and function of intrinsic nerves of the bladder and urethra.Neurourol Urodyn 1982;1:3–50Google Scholar
  14. 14.
    Elbadawi A, Atta MA. Ultrastructural analysis of vesicourethral innervation: evidence for somatomotor plus autonomic innervation of the feline rhabdosphincter.Neurourol Urodyn 1985;4:23–36Google Scholar
  15. 15.
    Kakizaki H, Koyanagi T, Shinno Y et al. An electromyographic study on the urethral rhabdosphincter in normal and chronically rhizotomized cats. Analysis of electrical potentials evoked by sympathetic nerve stimulation.J Urol 1994;151-238-243Google Scholar
  16. 16.
    de Groat WC, Kawatani M. Neural control of the urinary bladder: possible relationship between peptidergic inhibitory mechanisms and detrusor instability.Neurourol Urodyn 1985;4:285–300Google Scholar
  17. 17.
    Morgan CW, de Groat WC, Flekins LA. Axon collaterals indicate broad intraspinal role for sacral preganglionic neurons.Proc Natl Acad Sci USA 1991;88:6888–6892PubMedGoogle Scholar
  18. 18.
    White JC. Sensory innervation of the viscera: studies on visceral afferent neurons in man based on neurosurgical procedures for the relief of intractable pain.Res Publ Assoc Nerv Ment Dis 1943;23:373–390Google Scholar
  19. 19.
    Bahns E, Ernsberger U, Janig W, Nelke A. Functional characteristics of lumber visceral afferent fibers from the urinary bladder and urethra in the cat.Pflügers Arch 1986;407:510–518PubMedGoogle Scholar
  20. 20.
    Bahns E, Halsband U, Janig W. Responses of sacral visceral afferents from the lower urinary tract, colon, and anus to mechanical stimulation.Fflügers Arch 1987;410:296–303Google Scholar
  21. 21.
    Habler HJ, Janig W, Koltzenburg M. Activation of unmyelinated afferent fibers by mechanical stimuli and inflammation of the urinary bladder in the cat.J Physiol (London) 1990;425:545–562Google Scholar
  22. 22.
    Iggo A. Tension receptors in the stomach and urinary bladder.J Physiol (London) 1955;128:593–607Google Scholar
  23. 23.
    de Groat WC. Nervous control of the urinary bladder in the cat.Brain Res 1975;87:201–211PubMedGoogle Scholar
  24. 24.
    de Groat WC. Neuropeptides in pelvic afferent pathways.Experientia 1987;43:801–813PubMedGoogle Scholar
  25. 25.
    de Groat WC, Ryall RW. Reflexes to sacral parasympathetic neurones concerned with micturition in the cat.J Physiol (London) 1969;200:87–108Google Scholar
  26. 26.
    Mallory B, Steers WD, de Groat WC. Electrophysiological study of micturition reflexes in the rat.Am J Physiol 1989;257:R410-R421PubMedGoogle Scholar
  27. 27.
    Janig W, Morrison JFB. Functional properties of spinal visceral afferents supplying abdominal and pelvic organs, with special emphasis on visceral nociception. In: Cervero F, Morrison JFB, eds. Visceral sensation. Progress in brain research, Vol. 67. Amsterdam: Elsevier, 1986;87–114Google Scholar
  28. 28.
    McKenna KD, Nadelhaft I. The organization of the pudendal nerve in the male and female cat.J Comp Neurol 1985;248:532–549Google Scholar
  29. 29.
    Morgan C, Nadelhaft I, de Groat WC. The distribution of visceral primary afferents from the pelvic nerve within Lissauer’s tractand the spinal gray matter and its relationship to sacral parasympathetic nucleus.J Comp Neurol 1981;201:415–440PubMedGoogle Scholar
  30. 30.
    Roppolo JR, Nadelhaft I, de Groat WC. The organization of pudendal motoneurons and primary afferent projections in the spinal cord of the rhesus monkey revealed by horseradish peroxidase.J Comp Neurol 1985;234:475–487PubMedGoogle Scholar
  31. 31.
    Tanagho EA, Schmidet RA, Gomes de Araujo C. Urinary striated sphincter: what is its nerve supply?Urology 1982;20:415–417PubMedGoogle Scholar
  32. 32.
    Andrew J, Nathan PW. Lesions of the anterior frontal lobe and disturbances of micturition and defaecation.Brain 1964;87:233–261PubMedGoogle Scholar
  33. 33.
    Maurice-Williams RS. Micturition symptoms in frontal tumours.J Neurol Neurosurg Psychiatr 1974;37:431–436PubMedGoogle Scholar
  34. 34.
    Barrington FJF. The relation of the hind brain to micturition.Brain 1921;44:23–53Google Scholar
  35. 35.
    Barrington FJF. The effect of lesions of the hind and midbrain on micturition in the cat.Q J Exp Physiol 1925;15:181–202Google Scholar
  36. 36.
    Kuru M. Nervous control of micturition.Physiol Rev 1965;45:424–494Google Scholar
  37. 37.
    Satoh K, Shimizu N, Tohyama M, Maeda T. Localization of the micturition reflex at dorsolateral pontine tegmentum of the rat.Neurosci Lett 1978;8:27–33Google Scholar
  38. 38.
    Tang PC, Ruch TC. Localization of brainstem and diencephalic areas controlling the micturition reflex.J Comp Neurol 1956;106:213–245PubMedGoogle Scholar
  39. 39.
    Noto H, Roppolo JR, Steers WD, de Groat WC. Electrophysiological analysis of ascending and descending pathways of the micturition reflex in the rat.Brain Res 1991;549:95–105PubMedGoogle Scholar
  40. 40.
    Griffiths D, Holstege G, Dalm E, de Wall H. Control and coordination of bladder and urethral function in the brainstem of the cat.Neurourol Urodyn 1990;9:63–82Google Scholar
  41. 41.
    Holstege G, Griffiths D, de Wall H, Dalm E. Anatomical and physiological observations on supraspinal control of bladder and urethral sphincter muscles in cat.J Comp Neurol 1986;250:449–461PubMedGoogle Scholar
  42. 42.
    Kruse MN, de Goat WC. Micturition reflexes in decerebrate and spinalized neonatal rats.Am J Physiol 1990;258:R1508-R1511PubMedGoogle Scholar
  43. 43.
    Yoshimura N, Sasa M, Yoshida O, Takaori S. Mediation of the micturition reflex by central norepinephrine form the locus coeruleus in the cat.J Urol 1990;143:840–843PubMedGoogle Scholar
  44. 44.
    Smith ARB, Hosker GL, Warrell DW. The role of pudendal nerve damage in the aetiology of genuine stress incontinence in women.Br J Obstet Gynaecol 1989;96:29–32PubMedGoogle Scholar
  45. 45.
    Smith ARB, Hosker GL, Warrell DW. The role of partial denervation of the pelvic floor in the aetiology of genitourinary prolapse and stress incontinence of urine. A neurophysiological study.Br J Obstet Gynaecol 1989;96:24–28PubMedGoogle Scholar
  46. 46.
    Snooks SJ, Barnes PRH, Swash M. Damage to the innervation of the voluntary anal and periurethral sphincter musculature in incontinence: an electrophysiological study.J Neurol Neurosurg Psychiatr 1984;47:1269–1273PubMedGoogle Scholar
  47. 47.
    Anderson RS. A neurogenic element to urinary genuine stress incontinence.Br J Obstet Gynaecol 1984;91:412–415Google Scholar
  48. 48.
    Snooks SJ, Swash M. Abnormalities of the innervation of the urethral striated sphincter musculature in incontinence. Br J Urol 1984;56:401–405PubMedGoogle Scholar
  49. 49.
    Snooks SJ, Swash M. Perineal nerve and transcutaneous spinal stimulation: new methods for investigation of urethral striated sphincter musculature.Br J Urol 1984;56:406–409PubMedGoogle Scholar
  50. 50.
    Thind P, Lose G. The effect of bilateral pudendal blockade on the static urethral closure function in health females.Obstet Gynecol 1992;80:906–911PubMedGoogle Scholar
  51. 51.
    Allen RE, Hosker GL, Smith ARB, Warrell DW. Pelvic floor damage and childbirth: a neurophysiological study.Br J Obstet Gynaecol 1990;97:770–779PubMedGoogle Scholar
  52. 52.
    Benson JT, McCllelan E. The effect of vaginal dissection on the pudendal nerve.Obstet Gynaecol 1993;82:387–389Google Scholar
  53. 53.
    Trockman BA, Leach GE, Hamilton J, Sakamoto M, Santiago L, Zimmern PE. Modified Pereyra bladder neck suspension: 10 year follow-up using outcomes analysis in 125 patients.J Urol 1995;154:1841–1847PubMedGoogle Scholar
  54. 54.
    English SF, McGuire EJ, Cross CA. Normal pelvic floor function in women with a cystocele.J Urol 1997;157:317 (Abstract 1236)Google Scholar
  55. 55.
    Havenga K, Enker WE, McDermott K, Cohen AM, Minsky BD, Guillem J. Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum.J Am Coll Surg 1996;182:495–502PubMedGoogle Scholar
  56. 56.
    de Groat WC, Nadelhaft I, Milne RJ et al. Organization of the sacral parasympathetic reflex pathways in the urinary bladder and large intestine.J Autonom Nerv Syst 1981;3:135–165Google Scholar
  57. 57.
    Vera PL, Nadelhaft I. Conduction velocity distribution of afferent fibers innervating the rat urinary bladder.Brain Res 1990;520:83–89PubMedGoogle Scholar
  58. 58.
    Kruse MN, Noto H, Roppolo JR, de Groat WC. Pontine control of urinary bladder and external urethral sphincter in the rat.Brain Res 1990;532:182–190PubMedGoogle Scholar
  59. 59.
    Kruse MN, Mallory BS, Noto H, et al. Properties of the descending limb of the spinobulbospinal micturition reflex pathway in the cat.Brain Res 1991;556:6–12PubMedGoogle Scholar
  60. 60.
    Noto H, Roppolo JR, Steers WD, de Groat WC. Excitatory and inhibitory influences on bladder activity elicited by electrical stimulation of the pontine micturition center in the rat.Brain Res 1989;492:99–115PubMedGoogle Scholar
  61. 61.
    Barrington FJF. The component reflexes of micturition in the cat.Brain 1931;54:177–188Google Scholar
  62. 62.
    Gardy M, Kozminski M, DeLancey J, Elkins T, McGuire EJ. Stress incontinence and cystoceles.J Urol 1991;145:1211–1213PubMedGoogle Scholar
  63. 63.
    Shimoda N, Takakusaki K, Nishizawa O et al. The changes in the activity of pudendal motoneurons in relation to reflex micturition evoked in decerebrate cats.Neurosci Lett 1992;135:175–178PubMedGoogle Scholar
  64. 64.
    Fedirchuk B, Downie J, Shefchyk SJ. Reduction of perineal evoked excitatory postsynaptic potentials in cat lumbar and sacral motoneurons during micturition.J Neurosci 1994;14:6153–6159PubMedGoogle Scholar
  65. 65.
    van Waalwijk van Doorn ESC, Remmers A, Janknegt RA. Conventional and extramural ambulatory urodynamic testing of the lower urinary tract in female volunteers.J Urol 1992;147:1319–1325PubMedGoogle Scholar
  66. 66.
    McGuire EJ. Experimental observation on the integration of bladder and urethral function.Trans Am Assoc Genitourin Surg 1977;68:38Google Scholar
  67. 67.
    Bennett BC, Vizzard MA, Booth AM, de Groat WC. Role of nitric oxide in reflex urethral sphincter relaxation during micturition.Soc Neurosci Abstr 1993;19:511Google Scholar
  68. 68.
    Persson K, Igawa Y, Mattiasson A, Andersson KE. Effects of inhibition of thel-arginine/nitric pathway in the rat lower urinary tract in vivo and in vitro.Br J Pharmacol 1992;197:178–184Google Scholar
  69. 69.
    Persson K, Alm P, Johansson K et al. Nitric oxide synthase in pig lower urinary tract: immunohistochemistry, NADPH diaphorase histochemistry and functional effects.Br J Pharmacol 1993;110:521–530PubMedGoogle Scholar
  70. 70.
    Thornbury KD, Hollywood MA, McHale NG. Mediation by nitric oxide of neurogenic relaxation of the urinary bladder neck muscle in sheep.J Physiol (London) 1992;451:133–144Google Scholar
  71. 71.
    Mattiasson A, Andersson KE, Sjogren C. Adrenoceptors and cholinoceptors controlling noradrenaline release from adrendergic nerves in the urethra of rabbit and man.J Urol 1984;131:1190–1195PubMedGoogle Scholar
  72. 72.
    McGuire EJ. Reflex urethral instability.Br J Urol 1978;50:200–204PubMedGoogle Scholar
  73. 73.
    Petros PE, Ulmsten U. Bladder instability in women: a premature activation of the micturition reflex.Neurourol Urodyn 1993;12:235–239PubMedGoogle Scholar
  74. 74.
    Nanninga J, Frost F, Penn R. Effect of intrathecal baclofen on bladder and sphincter function.J Urol 1989;142:101–105PubMedGoogle Scholar
  75. 75.
    Roppolo JR, Booth AM, de Groat WC. The effects of naloxone on the neural control of the urinary bladder of the cat.Brain Res 1983;264:355–358PubMedGoogle Scholar
  76. 76.
    Steers WD, Meythaler JM, Herrell D et al. The effects of acute bolus and continuous intrathecal baclofen on genitourinary dysfunction in patients with disorders of the spinal cord.J Urol 1992;148:1849–1855PubMedGoogle Scholar
  77. 77.
    Nergardh A, Boreus LO. Autonomic receptor function in the lower urinary tract of man and cat.Scand J Urol Nephrol 1972;6:32–36PubMedGoogle Scholar
  78. 78.
    Nordling L. Influence of the sympathetic nervous system on lower urinary tract in man.Neurourol Urodyn 1983;2:3–45Google Scholar
  79. 79.
    Bors E, Comarr AE. Neurological urology. Baltimore: University Park Press, 1971Google Scholar
  80. 80.
    Gary T, Robertson D. Lessons learned from dopamineβ-hydroxylase deficiency in humans.News in Physiol Sci 1994;9:35–39Google Scholar
  81. 81.
    Holstege G. Some anatomical observations on the projections from the hypothalamus to brainstem and spinal cord: an HRP and autoradiographic tracing study in the cat.J Comp Neurol 1987;260:98–126PubMedGoogle Scholar
  82. 82.
    de Groat WC. Inhibition and excitation of sacral parasympathetic neurons by visceral and cutaneous stimuli in the cat.Brain Res 1971;33:499–503Google Scholar
  83. 83.
    Fall M, Erlandson BE, Carlsson CA, Lindstrom S. The effect of intravaginal electrical stimulation on the feline urethra and urinary bladder.Scand J Urol Nephrol Suppl 1978;44, part II:19Google Scholar
  84. 84.
    Fall M. Does electrostimulation cure urinary incontinence?J Urol 1984;131:664–667PubMedGoogle Scholar
  85. 85.
    Sato A, Sato Y, Suzuki A. Mechanism of the reflex inhibition of micturition contractions of the urinary bladder elicited by acupuncture-like stimulation in anesthetized rats.Neurosci Res 1992;15:189–198PubMedGoogle Scholar
  86. 86.
    Fall M, Lindstrom S. Electrical stimulation. A physiologic approach to the treatment of urinary incontinence.Urol Clin North Am 1991;18:393–407PubMedGoogle Scholar
  87. 87.
    Vodusek DB, Light JK, Libby JM. Detrusor inhibition induced by stimulation of pudendal nerve afferents.Neurourol Urodyn 1986;5:381–389Google Scholar
  88. 88.
    Garry RC, Roberts TDM, Todd JK. Reflexes involving the external urethral sphincter in the cat.J Physiol 1959;149:653–665PubMedGoogle Scholar
  89. 89.
    de Groat WC, Kawatani M, Booth AM. Enkephalinergic modulation of cholinergic transmission in parasympathetic ganglia of the cat urinary bladder. In: Hanin I, ed. Dynamics of cholinergic function. New York: Plenum Press, 1986;1007–1017Google Scholar
  90. 90.
    Kawatani M, Rutigliano M, de Groat WC. Selective facilitatory effects of vasoactive intestinal polypeptide on muscarinic mechanisms in sympathetic and parasympathetic ganglia of the cat. In: Hanin I, ed. Dynamics of cholinergic function. New York: Plenum Press, 1986;1057–1066Google Scholar
  91. 91.
    Kawatani M, Whitney T, Booth AM, de Groat WC. Excitatory effect of substance P in parasympathetic ganglia of cat urinary bladder.Am J Physiol 1989;257:R1450-R1456PubMedGoogle Scholar
  92. 92.
    Learmonth JR. A contribution to the neurophysiology of the urinary bladder in man.Brain 1931;54:147–176Google Scholar
  93. 93.
    Saum WR, de Groat WC. The actions of 5-hydroxytryptamine on the urinary bladder and on the vesical autonomic ganglia in the cat.J Pharmacol Exp Ther 1973;185:70–83PubMedGoogle Scholar
  94. 94.
    Theobald RJ, de Groat WC. The effects of purine nucleotides in transmission in vesical parasympathetic ganglia of the cat.J Autonom Pharmacol 1989;9:167–182Google Scholar
  95. 95.
    Somogyi GT, de Groat WC. Evidence for inhibitory nicotinic and facilitatory muscarinic receptors in cholinergic nerve terminals of the rat urinary bladder.J Autonom Nerv Syst 1992;37:89–98Google Scholar
  96. 96.
    Nishimura T, Akasu T, Krier J. Endothelin causes prolonged inhibition of nicotinic transmission in feline colonic parasympathetic ganglia.Am J Physiol 1991;261:G628-G633PubMedGoogle Scholar
  97. 97.
    Lindstrom S, Fall M, Carlsson CA, Erlandson BE. The neurophysiological basis of bladder inhibition in response to intravaginal electrical stimulation.J Urol 1983;129:405–410PubMedGoogle Scholar
  98. 98.
    Fall M, Eflandson BE, Nilson AE et al. Long-term intravaginal electrical stimulation in urge and stress incontinence.Scand J Urol Nephrol Suppl 1978;44:55–63Google Scholar
  99. 99.
    Susset J, Galea G, Manbeck K, Susset A. A predictive score index for the outcome of associated biofeedback and vaginal electrical stimulation in the treatment of female incontinence.J Urol 1995;153:1461–1466PubMedGoogle Scholar
  100. 100.
    Burnstock G, Satchell DG, Smythe A. A comparison of the excitatory and inhibitory effects of non-adrenergic, non-cholinergic nerve stimulation and exogenously applied ATP on a variety of smooth muscle preparations from different vertebrate species.Br J Pharmacol 1972;46:234–242PubMedGoogle Scholar
  101. 101.
    Levin RM, Ruggieri MR, Wein AJ. Functional effects of the purinergic innervation of the rabbit urinary bladder.J Pharmacol Exp Ther 1986;236:452–457PubMedGoogle Scholar
  102. 102.
    de Groat WC, Kawatani M, Hisamitsu T et al. Role of neuropeptides in the sacral autonomic reflex pathways of the cat.J Autonom Nerv Syst 1983;7:339–350Google Scholar
  103. 103.
    Gibson SJ, Polak JM, Arand P et al. A VIP/PHI pathway links urinary bladder and sacral spinal cord.Peptides (Suppl) 1986;7:205–219PubMedGoogle Scholar
  104. 104.
    Keast J, de Groat WC. Immunocytochemical characterization of pelvic neurons which project to the bladder, colon, and penis in rats.J Comp Neurol 189;288:387–400Google Scholar
  105. 105.
    Zoubek J, Somogyi GT, de Groat WC. A comparison of inhibitory effects of neuropeptide Y on rat urinary bladder, urethra, and vas deferens.Am Ju Physiol 1993;265:R537-R543Google Scholar
  106. 106.
    Mattiasson A, Ekstrom B, Andersson KE. Interaction between adrenergic and cholinergic nerve terminals in the urinary bladder of rabbit, cat and man.J Urol 1987;137:1017–1019PubMedGoogle Scholar
  107. 107.
    Vizzard MA, Erdman S, Forstermann U, de Groat WC. Differential expression of nitric oxide synthase in neural pathways to the urogenital organs (urethra, penis, urinary bladder) of the rat.Brain Res 1994;646:279–291PubMedGoogle Scholar
  108. 108.
    Williams JH, Brading A. Urethral sphincter: normal function and changes in disease. In: Daniel EE, Tomira T, Tschuida S, Watanabe M, eds. Sphincters. Boca Raton: CRC Press, 1992;315–338Google Scholar
  109. 109.
    Jensen D. Pharmacological studies of uninhibited neurogenic bladder: the influence of adrenergic excitatory and inhibitory drugs on the cystometrograms of neurological patients with normal and uninhibited bladder.Acta Neurol Scand 1981;64:401–426PubMedGoogle Scholar
  110. 110.
    Rohner T, Hannigan J, Sanford E. Altered in vitro adrenergic response of dog detrusor muscle after chronic bladder outlet obstruction.Urology 1978;11:357–361PubMedGoogle Scholar
  111. 111.
    Swierzewski S, III, Gormley EA, Belville W et al. The effect of terazosin in bladder function in the spinal cord injured patient.J Urol 1994;151:951–954PubMedGoogle Scholar
  112. 112.
    Christmas TJ, Kirby RS. Alpha-adrenoceptor blockers in the treatment of benign prostatic hyperplasia.World J Urol 1991;9:36–40Google Scholar
  113. 113.
    Gosling JA, Dixon JS, Lendon RG. The autonomic innervation of the human male and female bladder neck and proximal urethra.J Urol 1977;118:302–305PubMedGoogle Scholar
  114. 114.
    Dykstra DD, Sidi AA, Scott AB et al. Effects of botulinum A toxin on detrusor sphincter dyssynergia in spinal cord patients.J Urol 1988;139:919–922PubMedGoogle Scholar
  115. 115.
    Lapides J, Sweet RB, Lewis LW. Function of striated muscle in control of urination: II. Effect of complete skeletal muscle paralysis.Surg Forum 1955;6:613–615Google Scholar
  116. 116.
    Keast J, de Groat WC. Segmental distribution and peptide content of primary afferent neurons inervating the urogenital organs and colon of male rats.J Comp Neurol 1992;319:615–623PubMedGoogle Scholar
  117. 117.
    Maggi CA, Meli A. The role of neuropeptides in the regulation of the micturition reflex.J Autonom Pharmacol 1986;6:133–162Google Scholar
  118. 118.
    McNeill DL, Traugh NE, Vaidya AM et al. Origin and distribution of NADPH-diaphorase positive neurons and fibers innervating the urinary bladder of the rat.Neurosci Lett 1992;147:33–36PubMedGoogle Scholar
  119. 119.
    Su HC, Wharton J, Polkak JM et al. Calcitonin gene-related peptide immunoreactivity in afferent neurons supplying the urinary tract; combined retrograde tracing and immunohistochemistry.Neuroscience 1986;18:737–747Google Scholar
  120. 120.
    Cheng CL, Ma CP, de Groat WC. Effects of capsaicin and micturition and associated reflexes in rats.Am J Physiol 1993;265:R132–138PubMedGoogle Scholar
  121. 121.
    Maggi CA, Barbanti G, Santicioli P et al. Cystometric evidence that capsaicin-sensitive nerves modulate the afferent branch of micturition reflex in humans.J Urol 1989;142:150–154PubMedGoogle Scholar
  122. 122.
    Fowler CJ, Jewkes D, McDonald WI. Intravesical capsaicin for neurogenic bladder dysfunction.Lancet 1992;339:1239–1240PubMedGoogle Scholar
  123. 123.
    Giuliana R, Patacchi R, Brabanti G et al. Characterization of tachykinin neurokinin-2 receptor in the human urinary bladder by means of selective receptor antagonists and peptidase inhibitors.J Pharmacol Exp Ther 1993;267:590–595Google Scholar
  124. 124.
    Lecci A, Giuliani S, Patacchini R, Maggi C. Evidence against a peripheral role of tachykinins in the initiation of micturition reflexes in the anesthetized rat.J Pharmacol Exp Ther 1993;264:1327–1332PubMedGoogle Scholar
  125. 125.
    Lecci A, Giuliani S, Maggi CA. Effect of the NK-1 receptor antagonist GR 82,334 on reflexly-induced bladder contractions.Life Sci 1992;51:PL277-PL280PubMedGoogle Scholar
  126. 126.
    Dockray GJ, Sharkey KA. Neurochemistry of visceral afferent neurons. In: Cervero G, Morrison JFB, eds. Visceral sensation. Progress in brain research, vol 67. Amsterdam: Elsevier, 1986;133–148Google Scholar
  127. 127.
    Hisamitsu T, de Groat WC. Inhibitory effect of opioid peptides and morphine applied intrathecally and intracerebroventricularly on the micturition reflex in the cat.Brain Res 1984;298:51–65PubMedGoogle Scholar
  128. 128.
    Booth AM, Hisamitsu T, Kawatani M, de Groat WC. Regulation of urinary bladder capacity by endogenous opioid peptides.J Urol 1985;133:339–342PubMedGoogle Scholar
  129. 129.
    Herman RM, Wainberg MC, del Guidice P, Wellscher MD. The effect of low dose intrathecal morphine on impaired micturition reflexes in human subjects with spinal cord lesions.Anesthesia 1988;69:313Google Scholar
  130. 130.
    Mallory BS, Roppolo JR, de Groat WC. Pharmacological modulation of the pontine micturition center.Brain Res 1991;546:310–320PubMedGoogle Scholar
  131. 131.
    Roppolo JR, Mallory BS, Ragoowansi A, de Groat WC. Modulation of bladder function in the cat by application of pharmacological agents to the pontine micturition center.Abstr Soc Neurosci 1986;12:645 (Abstract)Google Scholar
  132. 132.
    Sillen U, Rubenson A, Hjalmas K. Central cholinergic mechanisms inl-dopa induced hyperactive urinary bladder of the rat.Urol Res 1982;10:239PubMedGoogle Scholar
  133. 133.
    Christmas TJ, Chapple CR, Kempster PA et al. The role of subcutaneous apomorphine in the treatment of Parkinsonian avoiding dysfunction.J Urol 1989;141:327A (Abstract)Google Scholar
  134. 134.
    de Groat WC. The effects of glycine, GABA, and strychnine on sacral parasympathetic preganglionic neurons.Brain Res 1970;18:542–544Google Scholar
  135. 135.
    Steers WD, Albo M, van Asselt E. Effects of serotonergic agonists on micturition and sexual function in the rat.J Drug Devel Res 1992;27:361–375Google Scholar
  136. 136.
    Wein AJ. Pharmacologic therapy for incontinence.Urology 1990;36:36–43Google Scholar
  137. 137.
    Westlund KN, Coulter JD. Descending projections of the locus coeruleus and subcoeruleus/medial parabrachial nuclei in monkey: axonal transport studies and dopamine beta hydroxylase immunocytochemistry.Brain Res Rev 1980;2:235–264Google Scholar
  138. 138.
    Yoshimura N, Sasa M, Yoshida O, Takaori S. Alpha-1 adrenergic receptor-mediated excitation from the locus coeruleus of the sacral parasympathetic preganglionic neuron.Life Sci 1990;47:789–797PubMedGoogle Scholar
  139. 139.
    Ekstrom B, Andersson KE, Mattiasson A. Urodynamic effects of intravesical instillation of terodiline in health volunteers and in patients with detrusor hyperactivity.J Urol 1992;148:1840–1843PubMedGoogle Scholar
  140. 140.
    Anonymous. Effects of terodiline on urinary incontinence among older non-institutionalized women. Terodiline in the Elderly American Multicenter Study Group.J Am Geriatric Soc 1993;41:915–922Google Scholar
  141. 141.
    Lepor H, Knapp-Maloney G, Sunshine H. A dose titration study evaluating terazosin, a selective, once-a-day alpha 1-blocker for the treatment of symptomatic benign prostatic hyperplasia.J Urol 1990;144:1393–1397PubMedGoogle Scholar
  142. 142.
    Caine M. Reflections on alpha blockade therapy for benign prostatic hyperplasia.Br J Urol 1995;75:265–270PubMedGoogle Scholar
  143. 143.
    Dray A, Nunan L. Supraspinal and spinal mechanisms in morphine-induced inhibition of reflex urinary bladder contractions in the rat.Neuroscience 1987;22:291–287Google Scholar
  144. 144.
    Sasa M, Yoshimura N. Locus coerulus noradrenergic neurons as a micturition center.Microscopy Res Tech 1994;29:226–230Google Scholar
  145. 145.
    Christmas TJ, Rode J, Chapple CR, Milroy EJG, Turner-Warwick RT. Nerve fibre proliferation in interstitial cystitis.Virchows Archiv A Pathol Anat 1990;416:447–451Google Scholar
  146. 146.
    Hohenfellner M, Nunes L, Schmidt RA et al. Interstitial cystitis: increased sympathetic innervation and related neuropeptide synthesis.J Urol 1992;147:587–591PubMedGoogle Scholar
  147. 147.
    Levine JD, Goetzl EJ, Basbaum AI. Contribution of the nervous system to the pathophysiology of rheumatoid arthritis and other polyarthrides.Rheum Dis Clin North Am 1987;13:369–383PubMedGoogle Scholar
  148. 148.
    Belvisi MG, Barnes PJ, Rogers DF. Neurogenic inflammation in the airways: characterisation of electric parameters for vagus nerve stimulation in the guinea pig.J Neurosci Meth 1990;32:159–167Google Scholar
  149. 149.
    Fall M, Lindstrom S. Transcutaneous electrical nerve stimulation in classic and nonulcer interstitial cystitis.Urol Clin North Am 1994;21:131–139PubMedGoogle Scholar
  150. 150.
    Melzack R, Wall PD. Pain mechanisms: a new theory.Science 1965;150:971–979PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • T. C. Chai
    • 1
  • W. D. Steers
    • 1
  1. 1.Department of UrologyUniversity of Virginia Health Sciences CenterCharlottesvilleUSA

Personalised recommendations