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Neural control of lower urinary tract and targets for pharmacological therapy

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Studies on the physiology and pharmacology of the lower urinary tract have brought new information and concepts about the complex neural control of micturition. There are many mechanisms, some proven and others not yet completely understood, in which pharmacological agents may act facilitating the filling, storage, and emptying of the bladder. This review describes the peripheral innervation and the main pathways involved in lower urinary tract control. It also presents potential targets for the treatment of voiding dysfunctions.

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Adenosine tri-phosphate


Botulinum toxin A


Adenyl cyclase-cyclic adenosine monophosphate




Central nervous system


Detrusor smooth muscle




External urethral sphincter


Interstitial cystitis


International Prostate Symptom Score


Internal urethral sphincter


Lower urinary tract


Muscarinic receptors


Nicotinic receptors


Non-cholinergic non-adrenergic






Nitric oxide


Neuropeptide Y


Overactive bladder


Painful bladder syndrome




Peripheral nervous system


Purinergic receptors




Substance P


Stress urinary incontinence


Vanilloid receptors




Vasoactive intestinal peptide


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Bortolini, M.A.T., Bilhar, A.P.M. & Castro, R.A. Neural control of lower urinary tract and targets for pharmacological therapy. Int Urogynecol J 25, 1453–1462 (2014).

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