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

== Spinal cord injury and neurogenic detrusor overactivity ==

* '''Normal micturition is associated with a spinobulbospinal reflex mediated by myelinated Aδ afferents.'''
** '''Unmyelinated C fibers are normally relatively insensitive to gradual distention of the urinary bladder.'''
* '''After spinal cord injury, a capsaicin-sensitive C fiber–mediated spinal reflex develops and may play a role in the development of DO.'''
** Unlike Aδ afferents which are normally unresponsive to low intravesical pressures, C fibers are more mechanosensitive, leading to the development of DO.
** Capsaicin sensitive C fibers have also been implicated in DO after upper motoneuron diseases, such MS.
** Treatment of neurogenic DO patients with intravesical capsaicin or another C-fiber neurotoxin, RTX, produces symptomatic improvement in a subpopulation of these patients.
* '''The bladder ice-water urodynamic test has been suggested as a research method to assess the C fiber–mediated micturition reflex but is not practiced clinically.'''
** In a healthy individual, ice-water in the bladder would elicit no response.
** In a bladder responsive to C fiber-mediated spinal reflexes, patients cannot retain the ice-water.