Electrical propagation in the renal pelvis, ureter and bladder

Abstract

Under normal conditions, following the passage of urine from the collecting duct, the urine is stored briefly in the renal pelvis before being transported through the ureter to the bladder where the urine is stored for a longer time (hours) before being voided through the urethra. The transport of urine from the renal pelvis to the bladder occurs spontaneously due to contractions of the muscles in the wall of the pelvis and ureter. Spontaneous contractions also occur in the detrusor muscle and are responsible for maintaining the bladder shape during the filling phase. These muscle contractions occur as result of electrical impulses, which are generated and propagated through different parts of the urinary tract. The renal pelvis and the ureter differ from the bladder in relation to the origin, characteristics and propagation of these electrical impulses. In the ureter, the electrical impulses originate mainly at the proximal region of the renal pelvis and are transmitted antegradely down the length of the ureter. The electrical impulses in the bladder, on the other hand, originate at any location in the bladder wall and can be transmitted in different directions with the axial direction being the prominent one. In this manuscript, an overview of the current state of research on the origin and propagation characteristics of these electrical impulses in the normal and pathological conditions is provided.

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Cardiac electrophysiology catheters for electrophysiological assessments of the lower urinary tract—A proof of concept ex vivo study in viable ureters

“…Despite its high prevalence, underlying mechanisms of OAB and the origins of NVC are not fully understood. Several hypotheses have been proposed which associate NVC with: i) spontaneous contractility of detrusor smooth muscle with interstitial cells behaving like pacemaker cells, and ii) propagation of the electrical signal from the ureter to the bladder . In the field of cardiology strikingly similar hypotheses have been applied to atrial fibrillation (the most common cardiac arrhythmia), which is frequently initiated by electrical signals propagating from pulmonary vein triggers to the atrium .…”

Introduction to ‘Electrical propagation in smooth muscle organs’

“…These techniques include unipolar vs. bipolar recordings; one, two or even three dimensional recordings and finally serosal vs. cutaneous recordings. Hammad (2015) describes a series of studies performed in three urological tissues; the renal pelvis, the ureters and the bladder and reveals a surprising variety in pacemaking locations and in the spread of excitation in these three organs.…”

“…Hammad () describes a series of studies performed in three urological tissues; the renal pelvis, the ureters and the bladder and reveals a surprising variety in pacemaking locations and in the spread of excitation in these three organs.…”