NEURONAL CIRCUITRY OF THE LOWER URINARY-TRACT - CENTRAL AND PERIPHERAL NEURONAL CONTROL OF THE MICTURITION CYCLE

A new presentation technique is introduced to describe the neuronal ci rcuitry involved in the control of the uropoetic system and its contro l mechanisms during the micturition cycle. This method is based on the preparation of flow charts and is applied to the discussion of four q ualitative models which are derived from the literature. Opinions conc erning the reflex arcs and supraspinal connections said to be involved in micturition and continence are different and sometimes contradicto ry. Little is known about how autonomic information from the lower uri nary tract is relayed to supraspinal structures. Information about sup raspinal (inter)connections and their function in micturition control is still fragmentary. The control mechanisms which terminate voiding a re not totally clear. Moreover, the role of the pelvic floor musculatu re in the control of the lower urinary tract is probably underestimate d. The flow charts presented in this paper contribute to the future de sign of a single complete qualitative model representing the general c entral and peripheral nervous connections and control mechanisms. Such a model would provide an approach for future research in neuromodulat ion and neurostimulation of the uropoetic system and a reduced version could be used for quantitative modelling, e.g. in neural network simu lations.