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The neural control of micturition

2008; Nature Portfolio; Volume: 9; Issue: 6 Linguagem: Inglês

10.1038/nrn2401

1471-0048

Clare J. Fowler, Derek Griffiths, William C. de Groat,

Neuroscience of respiration and sleep

Fowler and colleagues review the pathways and neurotransmitters in the brain, the spinal cord and the peripheral nervous system that regulate the lower urinary tract, and discuss how disruption of the control of micturition leads to incontinence. Micturition, or urination, occurs involuntarily in infants and young children until the age of 3 to 5 years, after which it is regulated voluntarily. The neural circuitry that controls this process is complex and highly distributed: it involves pathways at many levels of the brain, the spinal cord and the peripheral nervous system and is mediated by multiple neurotransmitters. Diseases or injuries of the nervous system in adults can cause the re-emergence of involuntary or reflex micturition, leading to urinary incontinence. This is a major health problem, especially in those with neurological impairment. Here we review the neural control of micturition and how disruption of this control leads to abnormal storage and release of urine.