Abstract
In order to restore bladder function, a system-oriented treatment may be more preferred than an organ-based treatment. Such system approach involves always modulation via the nervous system. Therefore, it is important to have some basic knowledge about the neural connections of the lower urinary tract. This chapter will provide this information on the innervation by peripheral nerves, how these lower urinary tract nerves connect with the central nervous system, and which central areas are important for continence and micturition. Furthermore, specific forebrain structures, which decide whether micturition may start or continence has to continue, are discussed. The reader will learn that urinary continence and micturition are controlled by separated pathways, which cross talk only at higher brain levels. When these pathways are damaged, it is not possible to maintain normal bladder function.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
De Groat WC, Griffiths D, Yoshimura N. Neural control of the lower urinary tract. Compr Physiol. 2015;5:327–96.
Morgan C, Nadelhaft I, De Groat WC. The distribution of visceral primary afferents from the pelvic nerve to Lissauer’s Tract and the spinal gray matter and its relationship to the sacral parasympathetic nucleus. J Comp Neurol. 1981;201:415–40.
Satchell P, Vaughan C. Bladder wall tension and mechanoreceptor discharge. Pflugers Arch. 1994;426:304–9.
Fall M, Lindström S, Mazieres L. A bladder-to-bladder cooling reflex in the cat. J Physiol. 1990;427:281–300.
Häbler HJ, Jänig W, Koltzenburg M. Activation of unmyelinated afferent fibres by mechanical stimuli and inflammation of the urinary bladder in the cat. J Physiol. 1990;425:545–62.
Blok BF. Central pathways controlling micturition and urinary continence. Urology. 2002;59:13–7.
Blok BF. Sacral neuromodulation for the treatment of urinary bladder dysfunction. Bioelectron Med. 2018;1:85–94.
Chandler MJ, Hobbs SF, Fu QG, Kenshalo DR Jr, Blair RW, Foreman RD. Responses of neurons in ventroposterolateral nucleus of primate thalamus to urinary bladder distension. Brain Res. 1992;571:26–34.
Krhut J, Tintera J, Bilkova K, Holy P, Zachoval R, Zvara P, et al. Brain activity on fMRI associated with urinary bladder filling in patients with a complete spinal cord injury. Neurourol Urodyn. 2017;36:155–9.
Barrington FJ. The effect of lesion of the hind- and mid-brain on micturition in the cat. Quart J Exp Physiol. 1925;15:81–102.
Holstege G, Griffiths D, de Wall H, Dalm E. Anatomical and physiological observations on supraspinal control of bladder and urethral sphincter muscles in the cat. J Comp Neurol. 1986;250:449–61.
Satoh K, Shimizu N, Tohyama M, Maeda T. Localization of the micturition reflex center at dorsolateral pontine tegmentum of the rat. Neurosci Lett. 1978;8:27–33.
Tang PC. Levels of brain stem and diencephalon controlling micturition reflex. J Neurophysiol. 1955;18:583–95.
Cho H, Kang T, Chang J, Choi YR, Park MG, Choi KD, et al. Neuroanatomical correlation of urinary retention in lateral medullary infarction. Ann Neurol. 2015;77:726–33.
Komiyama A, Kubota A, Hidai H. Urinary retention associated with a unilateral lesion in the dorsolateral tegmentum of the rostral pons. J Neurol Neurosurg Psychiatry. 1998;65:953–4.
Valentino RJ, Pavcovich LA, Hirata H. Evidence for corticotropin-releasing hormone projections from Barrington’s nucleus to the periaqueductal gray region and dorsal motor nucleus of the vagus in the rat. J Comp Neurol. 1995;363:402–22.
Blanco L, Yuste JE, Carillo-de Sauvage MA, Gomez F, Fernandez-Villalba E, Aviles-Olmos I, et al. Critical evaluation of the anatomical location of the Barrington nucleus: relevance for deep brain stimulation surgery of pedunculopontine tegmental nucleus. Neuroscience. 2013;247:351–63.
Loewy AD, Saper CB, Baker RP. Descending projections from the pontine micturition center. Brain Res. 1979;172:533–8.
Blok BF, Holstege G. Ultrastructural evidence for a direct pathway from the pontine micturition center to parasympathetic preganglionic motoneurons of the bladder of the cat. Neurosci Lett. 1997;222:195–8.
Blok BF, de Weerd H, Holstege G. The pontine micturition center projects to sacral cord GABA immunoreactive neurons in the cat. Neurosci Lett. 1997;233:109–12.
Sie JA, Blok BF, de Weerd H, Holstege G. Ultrastructural evidence for direct projections from the pontine micturition center to glycine-immunoreactive neurons in the sacral dorsal gray commissure in the cat. J Comp Neurol. 2001;429:631–7.
Konishi A, Itoh K, Sugimoto T, Yasui Y, Kaneko T, Takada M, et al. Leucine-enkephalin-like immunoreactive afferent fibers to pudendal motoneurons in the cat. Neurosci Lett. 1985;61:109–13.
Blok BF, Sturms LM, Holstege G. Brain activation during micturition in women. Brain. 1998;121:2033–42.
Blok BF, van Maarseveen JT, Holstege G. Electrical stimulation of the sacral dorsal gray commissure evokes relaxation of the external urethral sphincter in the cat. Neurosci Lett. 1998;249:68–70.
Blok BF, Holstege G. Two pontine micturition centers in the cat are not interconnected directly: implications for the central organization of micturition. J Comp Neurol. 1999;403:209–18.
Blok BF, Willemsen AT, Holstege G. A PET study on brain control of micturition in humans. Brain. 1997;120:111–21.
Huynh HK, Willemsen AT, Lovick TA, Holstege G. Pontine control of ejaculation and female orgasm. J Sex Med. 2013;10:3038–48.
Vaughan CW, Satchell PM. Role of sympathetic innervation in the feline continence process under natural filling conditions. J Neurophysiol. 1992;68:1842–9.
Blok BF, De Weerd H, Holstege G. Ultrastructural evidence for a paucity of projections from the lumbosacral cord to the pontine micturition center or M-region in the cat. J Comp Neurol. 1995;359:300–9.
Basbaum AI, Fields HL. Endogenous pain control systems: brainstem spinal pathways and endorphin circuitry. Annu Rev Neurosci. 1984;7:309–38.
Bandler R, Keay KA, Floyd N, Price J. Central circuits mediating patterned autonomic activity during active vs. passive emotional coping. Brain Res Bull. 2000;53:95–104.
Noto H, Roppolo JR, Steers WD, De Groat WC. Electrophysiological analysis of the ascending and descending components of the micturition reflex pathway in the rat. Brain Res. 1991;549:95–105.
Blok BF, Holstege G. Direct projections from the periaqueductal gray to the pontine micturition center (M-region). An anterograde and retrograde tracing study in the cat. Neurosci Lett. 1994;166:93–6.
Taniguchi N, Miyata M, Yachiku S, Kaneko S, Yamaguchi S, Numata A. A study of micturition inducing sites in the periaqueductal gray of the mesencephalon. J Urol. 2002;168:1626–31.
Griffiths D, Derbyshire S, Stenger A, Resnick N. Brain control of normal and overactive bladder. J Urol. 2005;174:1862–7.
Kavia RB, Dasgupta R, Fowler CJ. Functional imaging and the central control of the bladder. J Comp Neurol. 2005;493:27–32.
Michels L, Blok BF, Gregorini F, Kurz M, Schurch B, Kessler T, et al. Supraspinal control of urine storage and micturition in men: an fMRI study. Cereb Cortex. 2015;25:3369–80.
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;260:98–126.
Kuipers R, Mouton LJ, Holstege G. Afferent projections to the pontine micturition center in the cat. J Comp Neurol. 2006;494:36–53.
Valentino RJ, Page ME, Luppi PH, Zhu Y, Van Bockstaele E, Aston-Jones G. Evidence for widespread afferents to Barrington's nucleus, a brainstem region rich in corticotropin-releasing hormone neurons. Neuroscience. 1994;62:125–43.
Fuchs SA, Edinger HM, Siegel A. The organization of the hypothalamic pathways mediating affective defense behavior in the cat. Brain Res. 1985;330:77–92.
Yardley CP, Hilton SM. The hypothalamic and brainstem areas from which the cardiovascular and behavioural components of the defence reaction are elicited in the rat. J Auton Nerv Syst. 1986;15:227–44.
Andrew J, Nathan PW. Lesions of the anterior frontal lobes and disturbances of micturition and defaecation. Brain. 1964;87:233–62.
Albanese A, Jenner P, Marsden CD, Stephenson JD. Bladder hyperreflexia induced in marmosets by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Neurosci Lett. 1988;87:46–50.
Bradley WE, Teague CT. Cerebellar regulation of the micturition reflex. J Urol. 1969;101:396–9.
Zago T, Pea U, Fumagalli GL, Areta L, Marzorati G, Bianchi F. Cerebellar pathology and micturitional disorders: anatomotopographic and functional considerations. Arch Ital Urol Androl. 2010;82:177–80.
Pavlakis AJ, Siroky MB, Golstein I, Krane RJ. Neurourologic findings in Parkinson’s disease. J Urol. 1983;129:80–3.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Blok, B.F.M. (2018). Neuroanatomy Relevant for the Urologist. In: Dmochowski, R., Heesakkers, J. (eds) Neuro-Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-90997-4_1
Download citation
DOI: https://doi.org/10.1007/978-3-319-90997-4_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-90995-0
Online ISBN: 978-3-319-90997-4
eBook Packages: MedicineMedicine (R0)