School of Medicine, Renal-Electrolyte Division, University of Pittsburgh, A1219 Scaife Hall, Pittsburgh, PA, 15261, USA.
Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA.
Pediatr Nephrol. 2021 May;36(5):1041-1052. doi: 10.1007/s00467-020-04594-4. Epub 2020 May 15.
The effective storage of urine and its expulsion relies upon the coordinated activity of parasympathetic, sympathetic, and somatic innervations to the lower urinary tract (LUT). At birth, all mammalian neonates lack the ability to voluntary regulate bladder storage or voiding. The ability to control urinary bladder activity is established as connections to the central nervous system (CNS) form through development. The neural regulation of the LUT has been predominantly investigated in adult animal models where comparatively less is known about the neonatal and postnatal neurophysiological development that facilitate urinary continence. Furthermore, congenital neurological or anatomical defects can adversely affect both storage and voiding functions through postnatal development and into adulthood, leading to secondary conditions including vesicoureteral reflux, chronic urinary tract infections, and end-stage renal disease. Therefore, the aim of the review is to provide the current knowledge available on neurophysiological regulation of the LUT through pre- to postnatal development of human and animal models and the consequences of congenital anomalies that can affect LUT neural function.
尿液的有效储存和排出依赖于副交感神经、交感神经和躯体神经对下尿路（LUT）的协调活动。出生时，所有哺乳动物新生儿都缺乏自主调节膀胱储存或排空的能力。控制膀胱活动的能力是通过发育与中枢神经系统（CNS）建立联系而确立的。LUT 的神经调节主要在成年动物模型中进行研究，而关于促进尿控的新生儿和产后神经生理发育的知识相对较少。此外，先天性神经或解剖缺陷会通过产后发育和成年期对储存和排空功能产生不利影响，导致继发性疾病，包括膀胱输尿管反流、慢性尿路感染和终末期肾病。因此，本综述的目的是提供关于人类和动物模型从产前到产后 LUT 的神经生理调节的现有知识，以及可能影响 LUT 神经功能的先天性异常的后果。
