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Neural control of lower urinary tract and targets for pharmacological therapy

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Abstract

Studies on the physiology and pharmacology of the lower urinary tract have brought new information and concepts about the complex neural control of micturition. There are many mechanisms, some proven and others not yet completely understood, in which pharmacological agents may act facilitating the filling, storage, and emptying of the bladder. This review describes the peripheral innervation and the main pathways involved in lower urinary tract control. It also presents potential targets for the treatment of voiding dysfunctions.

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Abbreviations

5-HT:

Serotonin

Ach:

Acetylcholine

AR:

Adrenoceptor

ATP:

Adenosine tri-phosphate

BTX-A:

Botulinum toxin A

cAMP:

Adenyl cyclase-cyclic adenosine monophosphate

CCK:

Cholecystokinin

CNS:

Central nervous system

DSM:

Detrusor smooth muscle

ENK:

Enkephalin

EUS:

External urethral sphincter

IC:

Interstitial cystitis

IPSS:

International Prostate Symptom Score

IUS:

Internal urethral sphincter

LUT:

Lower urinary tract

M:

Muscarinic receptors

N:

Nicotinic receptors

NANC:

Non-cholinergic non-adrenergic

NE:

Noradrenaline

NK:

Neurokinin

NO:

Nitric oxide

NPY:

Neuropeptide Y

OAB:

Overactive bladder

PBS:

Painful bladder syndrome

PGs:

Prostaglandins

PNS:

Peripheral nervous system

P2X:

Purinergic receptors

RTX:

Resiniferatoxin

SP:

Substance P

SUI:

Stress urinary incontinence

TRPV:

Vanilloid receptors

TX:

Thromboxane

VIP:

Vasoactive intestinal peptide

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  1. Sector of Urogynecology and Vaginal Surgery, Department of Gynecology, Federal University of São Paulo, Rua Rodolfo Belz, 220/42A, São Paulo, 05639-010, SP, Brazil

    Maria Augusta T. Bortolini, Andreisa P. M. Bilhar & Rodrigo A. Castro

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  1. Maria Augusta T. Bortolini
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  2. Andreisa P. M. Bilhar
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  3. Rodrigo A. Castro
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Bortolini, M.A.T., Bilhar, A.P.M. & Castro, R.A. Neural control of lower urinary tract and targets for pharmacological therapy. Int Urogynecol J 25, 1453–1462 (2014). https://doi.org/10.1007/s00192-014-2452-4

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