Neurophysiology in neurourology

Roberts, Margaret M.

doi:10.1002/mus.21001

Cited by 30 publications

(20 citation statements)

References 137 publications

(295 reference statements)

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“…3,7 Those fibers intermingle with somatic efferents from spinal nerves and synapse in one of the nearby paravertabral ganglia of the sympathetic chain, which continue peripherally with associated somatic segmental fibers. 5,6 Alternatively, some fibers pass through the paravertabral ganglia and synapse with one of the prevertebral or collateral ganglia on the aorta or internal iliac vessels, such as the inferior mesenteric ganglia, then continue inferiorly as the hypogastric nerves. Some fibers pass through both pre-and paravertebral ganglia and synapse with the end organ.…”

Section: Neuroanatomy and Neurophysiology Of The Urinary Systemmentioning

confidence: 99%

“…The nerve fibers travel within the pudendal nerve to the external urethral sphincter. 3,5,6 In addition, afferent nerves are located in the detrusor muscle and the suburothelium. 8 The afferent nerve fibers form plexiform structures beneath the urothelial lining (more prominent in the trigone and bladder neck and relatively sparse in the bladder dome), with some nerve ends extending into the urothelium.…”

Section: Neuroanatomy and Neurophysiology Of The Urinary Systemmentioning

confidence: 99%

“…Some fibers pass through both pre-and paravertebral ganglia and synapse with the end organ. 5,6 The main neurotransmitter for postganglionic sympathetic fibers is norepinephrine, and for preganglionic sympathetic fibers it is ACh. 5,6 The preganglionic somatic efferent nerves originate from the nucleus of Onuf (at S2-S4) in the Abbreviations: ACh, acetylcholine; AIDS, acquired immune deficiency syndrome; AL, amyloid light chain; BD, bladder dysfunction; CIDP, chronic inflammatory demyelinating polyneuropathy; CMT, Charcot-Marie-Tooth; DM, diabetes mellitus; EMG, electromyography; FAP, familial amyloid polyneuropathy; GBS, Guillain-Barré syndrome; HIV, human immunodeficiency virus; MCV, motor conduction velocity; nAChR, nicotinic acetylcholine receptor; SCV, sensory conduction velocity; TTR, transthyretin; UTI, urinary tract infection; Vds, vesical denervation supersensitivity sacral spinal cord.…”

Section: Neuroanatomy and Neurophysiology Of The Urinary Systemmentioning

confidence: 99%

“…3 Acetylcholine (ACh) is the main neurotransmitter for both pre-and postganglionic parasympathetic fibers. [4][5][6] The preganglionic sympathetic efferent fibers arise from the thoracolumbar segment of the spinal cord at T10-L2. 3,7 Those fibers intermingle with somatic efferents from spinal nerves and synapse in one of the nearby paravertabral ganglia of the sympathetic chain, which continue peripherally with associated somatic segmental fibers.…”

Section: Neuroanatomy and Neurophysiology Of The Urinary Systemmentioning

confidence: 99%

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Bladder dysfunction in peripheral neuropathies

et al. 2011

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Normal bladder function depends on the complex interaction of sensory and motor pathways. Bladder dysfunction can develop as a result of several neurological conditions. It can happen in a number of ways, including diabetic cystopathy, detrusor overactivity, bladder outlet obstruction, and urge and stress urinary incontinence. Diabetic neuropathy is the most common cause of peripheral neuropathy-associated bladder dysfunction. Guillain-Barré syndrome (GBS), human immunodeficiency virus (HIV)-associated neuropathy, chronic inflammatory demyelinating polyneuropathy (CIDP), and amyloid neuropathy are other major causes. The diagnosis of bladder dysfunction should be established by the history of neurological symptoms, neurological examination, and urological evaluation. Functional evaluation of the lower urinary tract includes cystometry, sphincter electromyography, uroflowmetry, and urethral pressure profilometry. Management of urinary symptoms in patients with bladder dysfunction is usually supportive. In some cases, alpha-blocker and/or anti-muscarinic agents are needed to help improve urinary dysfunction. Intermittent self-catheterization is needed occasionally for patients with slow and/or poor recovery.

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Section: Neuroanatomy and Neurophysiology Of The Urinary Systemmentioning

confidence: 99%

Section: Neuroanatomy and Neurophysiology Of The Urinary Systemmentioning

confidence: 99%

Section: Neuroanatomy and Neurophysiology Of The Urinary Systemmentioning

confidence: 99%

Section: Neuroanatomy and Neurophysiology Of The Urinary Systemmentioning

confidence: 99%

See 2 more Smart Citations

Bladder dysfunction in peripheral neuropathies

et al. 2011

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“…It is often identified after a patient presents with urinary retention and complaints of recurrent urinary tract infection, urinary frequency, nocturia, or even incontinence, but patients with chronic urinary retention may be asymptomatic in spite of large volume retention (1000 mL) and associated upper urinary tract injury. 2 Methods of examination which have been used to investigate the atonic bladder include urodynamic tests to determine bladder function, cystograms to evaluate for vesicoureteral reflux, and cystoscopy to evaluate bladder anatomy. Evaluation of the central nervous system should be completed when appropriate.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic giant atonic bladder (6000 mL in volume) that is present for 15 years with no urinary symptoms

Yorulmaz

Kısmet

et al. 2013

CUAJ

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Urinary retention is common in patients with neurologic disorders. We present a case of asymptomatic idiopathic giant bladder from which 6000 mL urine was drained. This is the largest volume of bladder that we found in the literature. T he urinary bladder is an unusual structure in that it is autonomically innervated yet functions under voluntary control. Although it is well-known that patients with a variety of neurological diseases suffer disturbances of continence and micturition, the precise ways in which these disorders affect the neurophysiological mechanisms of the bladder are poorly understood. Indeed, when a patient presents with urinary dysfunction, it is often difficult to be certain whether there is a neurological basis for the symptoms, or whether they are purely the result of a local abnormality, such as bladder outflow obstruction. 1 We present a case of giant bladder from which 6000 mL urine was drained via a urinary catheter. This is the largest volume of bladder that we found in the literature. The patient was asymptomatic except for abdominal distention, and we could not find any disorder that might be the cause of this massive bladder distention. Case reportA 62-year-old male was admitted to our hospital with the complaint of rectal bleeding after defecation for 2 months. He also lost 3 kilograms of weight during this period. On physical examination, significant abdominal distention was detected (Fig. 1). From the patient's history, we learned that he had a gradual increase of this distension for 15 years. He had no urinary complaints. A vegetative and polipoid mass was detected in the rectum 8 to 10 cm from the anal verge by rectoscopy and biopsies were taken. After having the histopathologic diagnosis as adenocarcinoma of the rectum, the patient underwent surgical operation. All preoperative laboratory tests, including urea and creatinine, were within normal values. Preoperative ultrasonography revealed a 24 × 23-cm cystic mass filling abdomen and pelvis. Computerized tomography (CT) also confirmed a 24 × 23 × 13-cm cystic mass with a delicate capsule and firm septations that supposedly originated from the mesentery (Fig. 2). The bladder could not be visualized probably due to inadequate filling with radiopaque substance. The rectal wall was thick along 5 cm of length. In the operating room, a urinary catheter was inserted for urinary outflow follow-up. After catheterization, 6000 mL of urine was drained, and the abdominal distention disappeared (Fig. 3). Laparotomy was performed and it was seen that there was no cystic mass in the abdominal cavity except for atonic bladder; so we decided that the cause of abdominal distention was atonic bladder, not another cystic mass (Fig. 4). Low anterior resection was performed. The tumour did not invade surrounding tissues and it was easily removed. Anastomosis was performed by stapler. A giant atonic bladder was detected, and a urologist was consulted during surgery. Since the patient had no obvious urinary complaints until the operation, he ...

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Muscle‐selective block using intrafascicular high‐frequency alternating current

2010

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High-frequency alternating current (HFAC) applied to a peripheral nerve can reversibly block skeletal muscle contractions. We evaluated the ability of HFAC delivered via intrafascicular electrodes to selectively block activation of targeted muscles without affecting activation of other muscles. Utah slanted electrode arrays (USEAs) were implanted into the sciatic nerves of five cats, and HFAC was delivered to individual USEA electrodes. The effects of HFAC block were monitored by recording evoked electromyograms (EMGs) and three-dimensional endpoint forces. In each animal, activity evoked in targeted muscles by nerve cuff stimulation could be selectively abolished by HFAC delivered via individual USEA electrodes. Two mechanisms of blockade were evoked: selective neuromuscular blocks were achieved with 500-8000-HZ HFAC, and selective nerve conduction block was achieved in one animal using 16-kHZ HFAC. These results show that intrafascicular HFAC can be used to block selected muscles independent of activation of other muscles.

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Neurophysiology in neurourology

Cited by 30 publications

References 137 publications

Bladder dysfunction in peripheral neuropathies

Bladder dysfunction in peripheral neuropathies

Idiopathic giant atonic bladder (6000 mL in volume) that is present for 15 years with no urinary symptoms

Muscle‐selective block using intrafascicular high‐frequency alternating current

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