Neuronal circuitry of the lower urinary tract; central and peripheral neuronal control of the micturition cycle

Abstract

(1995). Neuronal circuitry of the lower urinary tract : central and peripheral neuronal control of the micturition cycle. Anatomy and Embryology, 192(3), 195-209. DOI: 10.1007 /BF00184744General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal ? Take down policyIf you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Anat Embryol (1995) 192:195-209 9 Springer-Verlag 1995 Abstract A new presentation technique is introduced to describe the neuronal circuitry involved in the control of the uropoEtic system and its control mechanisms during the micturition cycle. This method is based on the preparation of flow charts and is applied to the discussion of four qualitative models which are derived from the literature. Opinions concerning the reflex arcs and supraspinal connections said to be involved in micturition and continence are different and sometimes contradictory. Little is known about how autonomic information from the lower urinary tract is relayed to supraspinal structures. Information about supraspinal (inter)connections and their function in micturition control is still fragmentary. The control mechanisms which terminate voiding are not totally clear. Moreover, the role of the pelvic floor musculature in the control of the lower urinary tract is probably underestimated. The flow charts presented in this paper contribute to the future design of a single complete qualitative model representing the general central and peripheral nervous connections and control mechanisms. Such a model would provide an approach for future research in neuromodulation and neurostimulation of the uropoetic system and a reduced version could be used for quantitative modelling, e.g. in neural network simulations.

A Method for the Electromyographic Mapping of the Detrusor Smooth Muscle

“…The complexity of the neuronal control of the lower urinary tract was clearly shown in recent studies (Marani et al, 1993;Kinder et al, 1995;Bastiaanssen, 1996). The conventional technique used to evaluate bladder functioning consists of an intravesical and rectal pressure measurement (ICS, 1987(ICS, , 1988.…”

Comparison of different computer models of the neural control system of the lower urinary tract

“…This reflex is generally accepted to be important in lower urinary tract control [Kinder et al, 1995]. In the subsequent models, structures-of which the function in the neural control is not clear-were added.…”

Introduction to this Special Issue on Neurology

“…The complex biological situation, the limitations of the research tools available and the prevailing equivocal anatomical nomenclature have contributed to the present dissension in literature (Kinder et al, 1995). To give some examples of the problems encountered: Within the peripheral connections in human an obstacle for the study is the broad variability of the pathways present, e.g., the constitution of a peripheral nerve in the cauda equina has recently been shown to contain a greater variability than expected (Mersdorf et al, 1993).…”

“…Despite significant research efforts, reports in literature disagree about muscle morphology (Dröes, 1972;Van Ulden, 1975;Dixon & Gosling, 1987;Elbadawi, 1987aElbadawi, , 1987bVan Arsdalen & Wein, 1991), the architecture of peripheral and central innervation (Bradley et al, 1974;Blaivas, 1982;Morrison, 1987a;De Groat & Steers, 1990;Holstege & Griffiths, 1990;Marani et al, 1993), and the control strategies involved (Bradley et al, 1974;Blaivas, 1982;Morrison, 1987bMorrison, , 1987cDe Groat & Steers, 1990;Holstege & Griffiths, 1990). How the micturition process is organised in detail is not clear (for a review see Kinder et al, 1995).…”

“…However, these tests show a poor correlation with urodynamic findings in diabetic patients and seem, therefore, not reliable to determine causes for lower urinary tract dysfunction (Anten, 1989). Moreover, the integrity of descending tracts from the pons to the sacral spinal cord, that are part of the micturition reflex (Kinder et al, 1995), cannot yet be investigated selectively. No neurophysiological test is available to selectively check the functionality of the efferent parasympathetic nerve fibers that mediate the micturition reflex towards the bladder and, thus, bring on a bladder contraction.…”