Editing Functional: Neural Control of Storage and Voiding (section)

=== Efferent innervation ===

==== Autonomic nervous system ====
* '''<span style="color:#ff0000">Parasympathetic</span>'''
** '''Parasympathetic preganglionic neurons''' innervating the LUT are located in the lateral part of the sacral '''intermediate gray matter of the S2-S4 spinal cord in a region called the sacral parasympathetic nucleus'''
** Parasympathetic preganglionic neurons send axons through the ventral roots to peripheral ganglia, where they release the excitatory transmitter Ach.
** '''Parasympathetic postganglionic neurons are located in the detrusor wall layer as well as in the pelvic plexus'''
** '''Patients with cauda equina or pelvic plexus injury are neurologically decentralized but may not be completely denervated'''. Cauda equina injury allows possible afferent and efferent neuron interconnection at the level of the intramural ganglia.
** '''<span style="color:#ff0000">Activation contributes to voiding by (2):</span>'''
**# '''<span style="color:#ff0000">Excitation (contraction) of the bladder</span>'''
**# '''<span style="color:#ff0000">Inhibition (relaxation) of the urethra</span>''' [not the bladder base]
* '''<span style="color:#ff0000">Sympathetic</span>'''
** '''<span style="color:#ff0000">Arises from the T11-L2 level of the spinal cord</span>'''
*** Sympathetic outflow from the rostral (anterior) lumbar spinal cord provides a noradrenergic excitatory and inhibitory input to the bladder and urethra
*** '''The peripheral sympathetic pathways follow a complex route''' that pass through the sympathetic chain ganglia to the inferior mesenteric ganglia and '''then through the hypogastric nerves to the pelvic ganglia'''
** '''<span style="color:#ff0000">Activation contributes to urine storage by (3):</span>'''
**# '''<span style="color:#ff0000">Inhibition (relaxation) of the bladder</span>'''
**# '''<span style="color:#ff0000">Excitation (contraction) of the bladder base</span>'''
**# '''<span style="color:#ff0000">Excitation (contraction) of the urethra</span>'''
** '''Animal studies have shown that sympathetic postganglionic fibers release noradrenaline (NA) and contribute to bladder relaxation during storage (via stimulation of β-adrenergic receptors expressed in detrusor)'''

==== Somatic nervous system ====
* '''<span style="color:#ff0000">The pudendal nerve arises from the S2-S4 level of the spinal cord</span>'''
** '''<span style="color:#ff0000">The motorneurons of the EUS are located along the lateral border of the ventral horn, commonly referred to as the Onuf nucleus</span>'''
* '''<span style="color:#ff0000">Activation contributes to urine storage by (1):</span>'''
*# '''<span style="color:#ff0000">Excitation (contraction) of the EUS</span>'''