Neurophysiology of Urinary Storage and Emptying-Neurophysiology of Urinary Storage and Emptying

Video Transcription

Video Summary

Dr. Stoffel’s talk reviewed the neurophysiology of urinary storage and emptying in the context of overactive bladder (OAB). He explained that bladder function depends on coordinated signaling between the bladder wall, peripheral nerves, and brain. Key bladder factors include detrusor muscle structure and the extracellular matrix, especially collagen and elastin, which affect bladder compliance and stretch.<br /><br />He discussed major receptor pathways: muscarinic receptors drive contraction during voiding, while beta-3 adrenergic receptors promote relaxation and storage. He compared anticholinergics and beta-3 agonists, noting similar efficacy but different side-effect profiles, and highlighted concerns about anticholinergic use and dementia risk. He also introduced newer targets such as sensory signaling in the urothelium/lamina propria, TRP channels, purinergic receptors, and nitric oxide pathways.<br /><br />The lecture emphasized that neuromodulation may work by improving afferent signaling and brain-bladder communication. He also described how stroke, spinal cord injury, and stress can disrupt central control of micturition. Finally, he noted that bladder pain syndromes and OAB share overlapping sensory pathways, especially involving C-fibers.

Keywords

overactive bladder

urodynamics

muscarinic receptors

beta-3 adrenergic receptors

neuromodulation

afferent signaling

bladder compliance