Central nervous targets for the treatment of bladder dysfunction

Neurourol Urodyn. 2014 Jan;33(1):59-66. doi: 10.1002/nau.22455. Epub 2013 Jul 5.


Background: The functions of the lower urinary tract, to store and periodically release urine, are dependent on the activity of smooth and striated muscles in the urinary bladder, urethra, and external urethral sphincter. This activity is in turn controlled by neural circuits in the brain, spinal cord, and peripheral ganglia.

Aims: This paper will review recent advances in our understanding of the pathophysiology of voiding disorders, especially focusing on the central nervous system.

Methods: Various neurotransmitters, including acetylcholine, norepinephrine, dopamine, serotonin, excitatory and inhibitory amino acids, adenosine triphosphate, nitric oxide, and neuropeptides, have been implicated in the neural regulation of the lower urinary tract.

Results: Injuries or diseases of the nervous system, as well as drugs and disorders of the peripheral organs, can produce voiding dysfunctions such as urinary frequency, urgency, or incontinence.

Conclusion: We discuss the potential targets in the central nervous system and new modalities for the treatment of voiding dysfunction.

Keywords: GABA; adenosine; bladder overactivity; central nervous system; gene therapy; glycine.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Animals
  • Brain / drug effects*
  • Brain / physiopathology
  • Central Nervous System Agents / therapeutic use*
  • Humans
  • Treatment Outcome
  • Urinary Bladder / drug effects*
  • Urinary Bladder / innervation
  • Urinary Bladder / physiopathology
  • Urinary Bladder, Overactive / drug therapy*
  • Urinary Bladder, Overactive / physiopathology
  • Urination / drug effects
  • Urodynamics / drug effects
  • Urological Agents / therapeutic use*


  • Central Nervous System Agents
  • Urological Agents