Neurological Control of Bladder Function

Neural Reflexes Governing Urinary Continence

The bladder’s function is intricately regulated by the nervous system, ensuring coordinated urine storage and voiding. This control involves both the central and peripheral nervous systems, including autonomic and somatic pathways.

Neural Pathways in Bladder Control

• The brainstem (pontine micturition center) modulates voluntary and reflexive bladder function.
• Sympathetic nerves (hypogastric nerve) facilitate urine storage by relaxing the detrusor muscle and contracting the internal sphincter.
• Parasympathetic nerves (pelvic nerve) promote urination by contracting the detrusor muscle.
• Somatic nerves (pudendal nerve) control voluntary contraction of the external urethral sphincter.

Urinary Reflexes

Two primary reflexes govern bladder function:

• Storage Reflex: Initiated by afferent signals from the bladder wall, the sympathetic system remains active to prevent involuntary emptying.
• Voiding Reflex: When bladder volume reaches a threshold, parasympathetic activation induces detrusor contraction, relaxing sphincters for urine expulsion.

Neurological Disorders Affecting Bladder Function

Conditions like spinal cord injuries, multiple sclerosis, and Parkinson’s disease disrupt neural control, leading to urinary retention or incontinence.

Management strategies include pharmacotherapy, neuromodulation, and behavioral therapy.