Lower urinary tract and prostate: structure and micturition physiology
Bladder and sphincter innervation and receptors, the spinal and pontine reflexes of micturition, how lesion level predicts bladder behaviour, prostate zones and androgen biology, and the pharmacology that follows from them.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- The bladder has two jobs: store at low pressure and empty completely on command. Storage is sympathetic and somatic. Voiding is parasympathetic.
- The pontine micturition centre (Barrington's nucleus) coordinates detrusor contraction with sphincter relaxation. The frontal cortex decides when.
- Lesion level predicts bladder behaviour: above the pons, overactive but coordinated; spinal cord, overactive and dyssynergic; sacral or peripheral, underactive with retention.
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Sources
- Campbell-Walsh-Wein Urology (12th ed.)Elsevier (Partin, Dmochowski, Kavoussi and Peters, 2020), 2020
- Guyton and Hall Textbook of Medical Physiology (14th ed.)Elsevier (Hall and Hall, 2021), 2021
- Sandhu JS et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline amendment 2023. J Urol 2024;211(1):11-19American Urological Association, 2023 (current amendment, checked November 2026)
- Fowler CJ, Griffiths D, de Groat WC. The neural control of micturition. Nat Rev Neurosci 2008;9(6):453-66Nature Reviews Neuroscience, 2008
- McConnell JD et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia (MTOPS). N Engl J Med 2003;349:2387-98New England Journal of Medicine, 2003
- Therapeutic Guidelines: Kidney and UrinaryAU/NZTherapeutic Guidelines Limited, 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback