Page 14 - Bladder Dysfunction in the Context of the Bladder-Brain Connection - Ilse Groenendijk.pdf

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Chapter 1
cortex, each representing a map of the whole body, known as the homunculus.2, 3 Other brain areas or systems thought to be involved in LUT control are the prefrontal cortex, the basal ganglia, the limbic system, the thalamus, the cerebellum, and the pons.2, 4
Spinal cord
T10-L2 S1-S4
Pontine micturition center
Hypogastric nerve (sympathetic)
Higher brain centers
Micturition reflex Micturition timing
Fig. 1. The innervation of the LUT
1.3 FUNCTIONAL UROLOGY - DISORDERS OF THE LUT
Pelvic nerve (parasympathetic)
Pudendal nerve (somatic)
Voluntary muscle
Bladder
LUT symptoms (LUTS) are divided into storage symptoms and voiding symptoms. The pathophysiology of LUT disorders is still unknown, but research suggests that it is multifactorial, with the pelvic floor muscles and the central innervation playing an important role.5, 6 The prevalence of LUTS worldwide ranges from 45% to 64%, which implies that about one in two people will experience at least one LUTS in their lives. Although the mortality of LUT disorders is very low, the negative impact on the quality of life (QoL) appears to be huge. Given the increase of symptoms with increasing age, and the steady increase in life expectancy, LUTS are a major healthcare problem with an
Pelvic floor Bladder sphincter