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The detrusor muscle, also known as the detrusor urinae muscle, is a smooth muscle found in the wall of the bladder that controls the release of urine. During urination, the detrusor muscle contracts to release urine, while the urethral sphincter muscles envelop the urethra to control the flow of urine. Additionally, the pelvic floor muscles play a crucial role in bladder control. These muscles support the bladder and coordinate with the urethra to control the flow of urine. Weakened pelvic floor muscles can lead to difficulties in controlling urination, while overly tight pelvic muscles can cause urinary urgency and frequency.
| Characteristics | Values |
|---|---|
| Name of the muscle that controls peeing | Detrusor muscle |
| Location | Wall of the bladder |
| Function | Contracts during urination to release urine |
| Related Muscles | Urethral sphincter muscles |
| Pelvic Floor Muscles Function | Control over peeing, along with bowel and bladder function (continence) |
| Pelvic Floor Muscles Conditions | Stress incontinence, urge incontinence, fecal incontinence, anal incontinence, pelvic organ prolapse |
| Pelvic Floor Muscles Exercise | Kegels |
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What You'll Learn
Pelvic floor muscles and their role in controlling the urethra
The pelvic floor muscles, along with connective tissues, support and hold important organs in the pelvis, including the bladder, bowel (large intestine), and internal reproductive organs. They provide flexibility to assist with bodily functions like urination, defecation, and sex. The pelvic floor muscles also help protect the spine and organs by absorbing outside pressure from lifting, coughing, etc.
The pelvic floor muscles coordinate with organs like the urethra and the anus. Squeezing the pelvic muscles narrows these passages, preventing waste from escaping. Relaxing these muscles widens the urethra and anus, allowing for urination and defecation. Healthy pelvic floor muscles allow for automatic squeezing and relaxing. However, these muscles can also be controlled deliberately, similar to flexing a bicep.
Pelvic floor muscles operate differently depending on an individual's sex. They can become stressed during pregnancy, overuse (heavy lifting, chronic coughing, constipation), or due to hormone changes during menopause. Weakened pelvic floor muscles can lead to stress incontinence, resulting in urine leakage when laughing, coughing, sneezing, or lifting. Pelvic floor exercises, or Kegels, are effective in strengthening these muscles and treating incontinence issues.
In addition to the pelvic floor muscles, the detrusor muscle and urethral sphincters play crucial roles in controlling urination. The detrusor muscle is found in the wall of the bladder and remains relaxed to store urine. During urination, it contracts to release urine. The urethral sphincter muscles envelop the urethra, controlling the urine flow through contraction and relaxation.
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The detrusor muscle and its function during urination
The detrusor muscle, or detrusor urinae muscle, is a smooth muscle found in the wall of the bladder. It is also referred to as the muscularis propria of the urinary bladder. The detrusor muscle plays a crucial role in the storage and release of urine. During urination, the detrusor muscle contracts, forcing urine out of the bladder. At other times, it remains relaxed, allowing the bladder to fill up and store urine.
The function of the detrusor muscle is closely related to the urethral sphincter muscles. While the detrusor muscle contracts to release urine, the urethral sphincter muscles envelop the urethra and contract to control the flow of urine. These muscles work in coordination to ensure the smooth passage of urine from the bladder through the urethra and out of the body.
Neurological control of the detrusor muscle is quite complex, involving both the autonomic and somatic nervous systems. The sympathetic branch of the autonomic nervous system, specifically the hypogastric nerve (T12-L2), promotes relaxation of the detrusor muscle, facilitating urine retention. On the other hand, the parasympathetic branch, through the pelvic nerve (S2-S4), stimulates the contraction of the detrusor muscle, initiating urination.
As the bladder fills with urine, it stretches, and sensory nerves in the bladder wall detect this stretch. These sensory nerves transmit signals to the spinal cord, which then relays the information to the parasympathetic efferents, leading to the contraction of the detrusor muscle and subsequent urination. This process is known as the bladder stretch reflex and is observed in infants before voluntary control over urination is established during toilet training.
In older adults over 60 years of age, the detrusor muscle may cause difficulties in completely emptying the bladder, resulting in uncomfortable urinary retention. Additionally, conditions that obstruct urine outflow, such as benign prostatic hyperplasia, can lead to hypertrophy of the detrusor muscle fibres as they compensate for the increased workload.
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How the brain controls the bladder muscles and sphincters
The detrusor muscle is a smooth muscle found in the wall of the bladder. It remains relaxed to allow the bladder to store urine and contracts during urination to release it. The urethral sphincter muscles envelop the urethra and control the flow of urine when they contract. The detrusor muscle and the urethral sphincters are, therefore, the primary muscles involved in the process of urination.
The brain and the bladder must communicate to ensure that urination occurs at an appropriate time. As the bladder fills, it sends sensory information to the central nervous system, indicating that it is full and must be emptied soon. The brain then sends a signal to the pontine micturition center (PMC), a part of the brainstem, which in turn sends a signal to the bladder to initiate urination. The process of urination is thus partly controlled by reflexes and is partly under conscious control.
The forebrain is also involved in voluntary micturition control. Many brain regions provide direct input projections to the forebrain, including the lateral hypothalamic area (LHA), the medial preoptic area (POA), the bed nucleus of the stria terminalis (BNST), the anterior cingulate cortex (ACC), and the prelimbic cortex.
The spinal cord is the main pathway for nerve signals between the brain and the bladder. The lumbar sympathetic nerves, a bundle of nerves in front of the spine in the lower back, carry nerve signals that control urine storage in the bladder. The enteric nervous system (ENS) is another nerve pathway that controls the opening and closing of the sphincters. The ENS can also function independently, pushing food through the digestive system even if the brain no longer controls peristalsis.
In addition to the role of the brain and nervous system in controlling the bladder and sphincter muscles, the pelvic floor muscles also play a crucial role in bladder control. These muscles support the bladder and other pelvic organs and provide flexibility to assist with bodily functions like urination. Weakened pelvic floor muscles can lead to stress incontinence, which is characterised by involuntary urination when laughing, coughing, sneezing, or lifting. Pelvic floor exercises, or Kegels, can help strengthen these muscles and improve bladder control.
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The impact of weakened pelvic floor muscles on urinary control
The pelvic floor muscles, along with other key muscle groups in the torso or core, play a crucial role in maintaining urinary control. These muscles support the bladder, bowel, and internal reproductive organs, holding them in place while allowing for the flexibility needed for bodily functions like urination. Weakened pelvic floor muscles can have a significant impact on urinary control, leading to various forms of incontinence.
One common sign of weakened pelvic floor muscles is stress incontinence, where individuals may experience peeing or dribbling during activities like laughing, coughing, sneezing, or lifting. This condition is more prevalent after childbirth, following prostate surgery, or in the event of a pelvic injury. Weakened pelvic muscles can also result in urge incontinence, characterised by a frequent and uncontrollable urge to urinate.
The ability to squeeze and relax the pelvic floor muscles is essential for maintaining urinary control. Pelvic floor muscles coordinate with the urethra and anus to control the passage of urine and stools. When the pelvic floor muscles are weak, individuals may struggle to squeeze these passages closed, leading to accidental urine leakage. Additionally, weakened pelvic floor muscles can affect the ability to hold urine in the bladder, resulting in a frequent and sudden need to urinate.
In addition to incontinence, weakened pelvic floor muscles can contribute to other conditions such as pelvic organ prolapse. This occurs when the pelvic organs, such as the uterus, rectum, or bladder, are not adequately supported and bulge into the vagina or cause a protrusion from its opening. Weakened pelvic floor muscles can also impact sexual function and contribute to pain in the pelvic, back, hip, or leg areas.
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The role of sensory nerves in signalling the need to urinate
The process of urination is a complex task involving the intricate coordination of the brain and bladder. The bladder is a muscular organ that stores urine until it is ready to be expelled from the body. The brain-bladder communication involves several areas of the brain, including the prefrontal cortex, hypothalamus, and brainstem. These regions receive signals from the bladder's sensory nerves, process the information, and generate appropriate responses.
The peripheral nervous system, which consists of nerves extending from the spinal cord to different body parts, plays a crucial role in the brain-bladder connection. The parasympathetic and sympathetic nerves are key players in this process. When the bladder is empty, the parasympathetic nerves are inactive, but as it fills with urine, these nerves become activated, signalling the detrusor muscle to relax and the bladder to expand. On the other hand, sympathetic nerves control the bladder's contraction and emptying phase. When it's time to urinate, they send signals to the detrusor muscle, triggering its contraction and enabling the bladder to expel urine.
The sensory nerves in the bladder wall detect the stretch as the bladder fills and transmits this information to the spinal cord. Interneurons within the spinal cord then relay the signal to the parasympathetic efferents (the pelvic nerve), which acts to contract the detrusor muscle and stimulate urination. This is known as the bladder stretch reflex, a primitive spinal reflex where urination is stimulated in response to the stretch of the bladder wall.
Maintaining a healthy brain-bladder connection is vital for optimal bladder function and overall urinary health. Conditions like overactive bladder (OAB) and urinary incontinence can arise when this connection is disrupted. OAB occurs when the nerves controlling bladder function become overactive, leading to involuntary bladder contractions and a frequent need to urinate. Urinary incontinence, or the involuntary leakage of urine, can result from weakened pelvic floor muscles, nerve damage, or hormonal changes. Pelvic floor exercises and maintaining a healthy brain-bladder connection are crucial for managing and preventing these conditions.
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Frequently asked questions
The detrusor muscle controls peeing. This muscle is found in the wall of the bladder and remains relaxed to allow the bladder to store urine. During urination, it contracts to release urine.
If the detrusor muscle doesn't function properly, it can cause issues with emptying the bladder, resulting in uncomfortable urinary retention. This can occur due to spinal cord injuries or neurodegenerative diseases.
The pelvic floor muscles work with the urethra to control the flow of urine. These muscles can be deliberately controlled, similar to flexing a bicep. The urethral sphincter muscles also envelop the urethra and contract to control the flow of urine.
Common signs of weakened pelvic floor muscles include struggling to control urination, known as stress incontinence. This can lead to accidental urine leakage when laughing, coughing, sneezing, or lifting.
Pelvic floor exercises, also known as Kegels, can help strengthen these muscles. These exercises involve routinely squeezing and relaxing the pelvic muscles to improve control.
