Central pathways that control the urinary bladder

In order to understand the role of the brain in the control of the urinary bladder and its sphincter, it is important to make a distinction between (1) Areas and pathways which are intrinsic part of the micturition and continence reflex, and (2) Areas and pathways which modulate these micturition and continence areas. Most of the clinical therapies aimed at alleviating functional bladder disorders are not specifically targeted on the central reflex areas, like the pontine micturition center (PMC), but influence cortical and subcortical brain areas which modulate the micturition reflex components. This chapter gives an overview of the central areas involved in the control of micturition and continence and highlights their role in the pathophysiology of functional bladder problems.

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