Affiliations: Department of Pharmacology, University of Pittsburgh,
Pittsburgh, PA 15261, USA
Note: [] Corresponding author: Changfeng Tai, Ph.D., Department of
Pharmacology, University of Pittsburgh, W1354 Biomedical Science Tower,
Pittsburgh, PA15261, USA. Tel.: +1 412 648 7016; Fax: +1 412 648 1945; E-mail:
[email protected]
Abstract: Purpose: This review summarizes possible spinal reflexes involved in
micturition control as well as current treatments for lower urinary tract
dysfunction after spinal cord injury (SCI) in an effort to further promote the
development of new treatments for people with SCI. Methods: A systematic literature search was conducted on the
Medline database, and on the Web of Science. Results: After SCI normal functions of the lower urinary tract
are lost. The detrusor contracts frequently even at a small bladder volume,
which results in urinary incontinence. In addition, the hyperactive bladder can
not empty well because the urethral sphincter contracts simultaneously with the
bladder (detrusor sphincter dyssynergia), which results in a large residual
volume of urine. The malfunction of the lower urinary tract after SCI is caused
by remaining and newly emerged bladder and urethral sphincter spinal reflexes.
Current treatments have either limited success or troublesome side effects, and
many new treatments are under development. Conclusions: In order to restore the functions of the lower
urinary tract after SCI, efforts should be directed at re-establishing the
coordination between the spinal reflex control of bladder and urethral
sphincter using either pharmacological or neurophysiological approaches.
