Neurophysiology of micturition and pharmacotherapy of lower urinary tract dysfunction

Both humans and animals, growing up, learn to voluntarily control micturition, in order to void only under suitable social and hygienic conditions. The physiological succession of storage and voiding phases is assured by a baseline neurological mechanism that interacts with a complex neuro-anatomic system, through both related and associated activities pattern, modifiable from environmental, social and behavioural factors. Micturition, as a final product of this complex mechanism entails a careful neurological control involving both central and peripheral (somatic and autonomic) nervous system. Aging, pelvic floor disorders, hypersensitivity disorders, morphologic bladder changes, neurological diseases, local inflammations, infections, and tumours, and bladder outlet obstruction may alter the normal voluntary micturition control, leading to urinary incontinence. The main aim of pharmacotherapy is to restore the normal micturition control inhibiting the emerging pathological involuntary reflex mechanism