Beckel Jonathan M, Holstege Gert
Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA 19104, USA.
Handb Exp Pharmacol. 2011(202):99-116. doi: 10.1007/978-3-642-16499-6_6.
The lower urinary tract (LUT), which consists of the urinary bladder and its outlet, the urethra, is responsible for the storage and periodic elimination of bodily waste in the form of urine. The LUT is controlled by a complex set of peripheral autonomic and somatic nerves, which in turn are controlled through neural pathways in the spinal cord and brain. This influence of the central nervous system allows for the conscious control of the bladder, allowing the individual to choose an appropriate place to urinate. Defects in the CNS pathways that control the LUT can lead to incontinence, an embarrassing condition that affects over 200 million people worldwide. As a first step in understanding the neural control of the bladder, we will discuss the neuroanatomy of the LUT, focusing first on the peripheral neural pathways, including the sensory pathways that transmit information on bladder filling and the motoneurons that control LUT muscle contractility. We will also discuss the organization of the central pathways in the spinal cord and brainstem that are responsible for coordinating bladder activity, promoting continuous storage of urine except for a few short minutes per day when micturition takes place. To conclude, we will discuss current studies underway that aim to elucidate the higher areas of the brain that control the voluntary nature of micturition in higher organisms.
下尿路（LUT）由膀胱及其出口尿道组成，负责以尿液的形式储存和定期排出身体废物。下尿路由一组复杂的外周自主神经和躯体神经控制，而这些神经又通过脊髓和大脑中的神经通路进行控制。中枢神经系统的这种影响使得膀胱能够受到有意识的控制，使个体能够选择合适的排尿地点。控制下尿路的中枢神经系统通路出现缺陷会导致尿失禁，这是一种令人尴尬的病症，全球有超过2亿人受其影响。作为了解膀胱神经控制的第一步，我们将讨论下尿路的神经解剖学，首先关注外周神经通路，包括传递膀胱充盈信息的感觉通路以及控制下尿路肌肉收缩力的运动神经元。我们还将讨论脊髓和脑干中负责协调膀胱活动的中枢通路的组织，这些通路促进尿液的持续储存，除了每天排尿的短短几分钟。最后，我们将讨论正在进行的当前研究，这些研究旨在阐明控制高等生物排尿自主性的大脑更高区域。
