What is the role of the brainstem in the neuroanatomy of neurogenic bladder?

Updated: Dec 06, 2018
  • Author: Bradley C Gill, MD, MS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

The brainstem is located at the base of the skull. Within the brainstem is the pons, a specialized area that serves as a major relay center between the brain and the bladder (see the image below). The pons is responsible for coordinating the activities of the urinary sphincters and the bladder. The mechanical process of urination is coordinated in an area of the pons known as the pontine micturition center (PMC). The PMC coordinates the urethral sphincter relaxation and detrusor contraction to facilitate urination. The pons relays afferent information from the bladder to higher brain centers, which in turn communicate with the periaqueductal gray matter, a relay station that collects higher brain center intput and processes this in order to signal the PMC to trigger or suppress the voiding reflex.  

The pons is a major relay center between the brain The pons is a major relay center between the brain and the bladder. The mechanical process of urination is coordinated by the pons in the area known as the pontine micturition center (PMC).

The conscious sensations associated with bladder activity are transmitted to the pons from the cerebral cortex. The interaction of a variety of excitatory and inhibitory neuronal systems influence the activity of the PMC, which by default attempts to trigger the voiding reflex. This voiding reflex causes the urethral sphincters to open while facilitating the detrusor to contract and expel the urine.


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