Classification of Lower Urinary Tract Dysfunction in the Female Patient

Abstract

Below, a brief review is given of the normal nervous control of the LUT and of some therapeutic principles used for treatment of urinary incontinence.nervous mechanisms for bladder emptying and urine storage The nervous mechanisms for bladder emptying and urine storage involve a complex pattern of afferent and efferent signaling in parasympathetic , sympathetic , and somatic nerves. These nerves constitute reflex pathways, which either maintain the bladder in a relaxed state, enabling urine storage at low intravesical pressure, or which initiate micturition by relaxing the outflow region and contracting the bladder smooth muscle. Under normal conditions, there is a reciprocal relationship between the activity in the detrusor and the activity in the outlet region. During voiding, contraction of the detrusor muscle is preceded by a relaxation of the outlet region, thereby facilitating the bladder emptying ( 5-7 ). On the contrary, during the storage phase, the detrusor muscle is relaxed, and the outlet region is contracted to maintain continence.