Neural control of the urinary bladder: Possible relationship between peptidergic inhibitory mechanisms and detrusor instability

Abstract

Abstract This paper provides a brief review of the organization of the neural mechanisms controlling micturition. The role of neuropeptides in peripheral afferent and efferent pathways and in the central reflex mechanisms is discussed. A major focus of the paper is on the inhibitory functions of spinal and supraspinal enkephalinergic systems in the control of bladder capacity and bladder stability. Pharmacological studies indicate that drug‐induced changes in enkephalinergic mechanisms can elicit marked alterations in bladder function. Similar changes in transmitter mechanisms may occur following neural injury or disease and therefore be involved in the development of neurogenic disorders of the lower urinary tract.