[Functional anatomy and semiology of the bladder].
Continence and micturition result from an inversely related evolution of urethra and bladder pressures. On filling, the bladder pressure remains low and the urethral pressure is high: filling bladder pressure mainly depends on its visco-elastic properties while urethral pressure is actively kept high by the tonic activity of smooth and striated urethral sphincters. It is the other, way round when the bladder empties: bladder pressure rises and urethral pressure lower, because the parasympathetic impulses; in the adult, the reflex loop passes through the pontine center. The volitional control of this micturitional reflex implies an ability to recognize a specific feeling: the desire to urinate. Physical examination and investigations enables to assess bladder and sphincter function, through a rich semiology.
Buzelin
Jean-Marie
JM
Service d'urologie CHU Hôtel-Dieu 44093 Nantes. jmbuzelin@chu-nantes.fr
D000328:Adult; D001746:Bladder Exstrophy / Q000175:diagnosis; D006801:Humans; D010808:Physical Examination; D014521:Urethra / Q000033:anatomy & histology / Q000502:physiology; D001743:Urinary Bladder / Q000002:abnormalities / Q000033:anatomy & histology* / Q000294:innervation / Q000502:physiology*; D001745:Urinary Bladder Diseases / Q000175:diagnosis* / Q000503:physiopathology; D014554:Urination / Q000502:physiology; D014555:Urination Disorders / Q000175:diagnosis* / Q000503:physiopathology; D014563:Urodynamics