The Role of Nitric Oxide and Hydrogen Sulfide in Urinary Tract Function

Basic Clin Pharmacol Toxicol. 2016 Oct:119 Suppl 3:34-41. doi: 10.1111/bcpt.12565. Epub 2016 Mar 18.


This MiniReview focuses on the role played by nitric oxide (NO) and hydrogen sulfide (H2 S) in physiology of the upper and lower urinary tract. NO and H2 S, together with carbon monoxide, belong to the group of gaseous autocrine/paracrine messengers or gasotransmitters, which are employed for intra- and intercellular communication in almost all organ systems. Because they are lipid-soluble gases, gaseous transmitters are not constrained by cellular membranes, so that their storage in vesicles for later release is not possible. Gasotransmitter signals are terminated by falling concentrations upon reduction in production that are caused by reacting with cellular components (essentially reactive oxygen species and NO), binding to cellular components or diffusing away. NO and, more recently, H2 S have been identified as key mediators in neurotransmission of the urinary tract, involved in the regulation of ureteral smooth muscle activity and urinary flow ureteral resistance, as well as by playing a crucial role in the smooth muscle relaxation of bladder outlet region. Urinary bladder function is also dependent on integration of inhibitory mediators, such as NO, released from the urothelium. In the bladder base and distal ureter, the co-localization of neuronal NO synthase with substance P and calcitonin gene-related peptide in sensory nerves as well as the existence of a high nicotinamide adenine dinucleotide phosphate-diaphorase activity in dorsal root ganglion neurons also suggests the involvement of NO as a sensory neurotransmitter.

Publication types

  • Review

MeSH terms

  • Animals
  • Humans
  • Hydrogen Sulfide / metabolism*
  • Models, Biological*
  • Motor Neurons / physiology
  • Muscle Relaxation
  • Muscle, Smooth / blood supply
  • Muscle, Smooth / innervation
  • Muscle, Smooth / physiology
  • Muscle, Smooth, Vascular / innervation
  • Muscle, Smooth, Vascular / physiology
  • Nerve Endings / physiology
  • Neurons, Afferent / physiology
  • Nitric Oxide / metabolism*
  • Urinary Tract / blood supply
  • Urinary Tract / innervation
  • Urinary Tract / metabolism*
  • Urinary Tract Physiological Phenomena*


  • Nitric Oxide
  • Hydrogen Sulfide