Physiology · Renal Physiology

Micturition and neural control

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Definition

  • Micturition is the process of passing urine, primarily a spinal reflex integrated in the sacral S2, S3, S4 segments of the cord, modulated by higher (brainstem and cortical) centres.
  • The reflex is normally triggered at a bladder volume of about 300 to 400 mL.

Innervation and Urethral Sphincters

Nerve supply of the urinary bladder

Fibre type

Parasympathetic

Origin
Sacral S2, S3, S4
Nerve
Pelvic nerve
Action
Efferent: detrusor contraction. Afferent: carries filling, desire and pain sensation

Sympathetic

Origin
Lumbar L1, L2, L3
Nerve
Hypogastric nerve
Action
Normally no role in micturition; contracts bladder to prevent semen entering it during ejaculation

Somatic

Origin
Sacral S2, S3, S4
Nerve
Pudendal nerve
Action
Innervates external sphincter; voluntary control