Arch Dis Child 2000;83:135-137
( August )
Current topic
Detrusor instability; day and night time wetting, urinary tract
infections
Ross Fisher, David Frank
Royal Bristol
Hospital for Sick Children, St Michael's Hill, Bristol BS2 8BJ,
UK
Correspondence to: Dr Frank email: edu@bui.ac.uk
Accepted 8 May 2000
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
Normal bladder function is the product of the complex
interaction between storage and emptying. It requires a compliant
bladder of adequate volume, and effective sphincter and detrusor
muscles with appropriately coordinated contraction and relaxation.
Storage is facilitated by release of noradrenaline from the branches of
the sympathetic nervous system stimulating contraction of the
sphincters in the bladder neck and posterior urethra accompanied by
relaxation of the detrusor. Bladder emptying is effected by the
parasympathetic nervous system. Acetylcholine, released from the
preganglionic nerves (S2-S4), stimulates contraction of the detrusor.
In infancy, this is accompanied by simultaneous sphincter relaxation.
Toilet training superimposes supraspinal polysynaptic reflexes on this
system such that inhibition and initiation of detrusor contractions as
well as sphincteric relaxation are essentially under voluntary control.
A bladder is defined as unstable if urodynamic investigation shows
detrusor contractions during the filling phase while the patient is
attempting to inhibit voiding. Contractions occurring . . . [Full text of this article]