PURPOSE: The physiopathology of the voiding and urinary continence was one of the hot topic of research these last few years. Unfortunately, anyone have already found a unique cause which could explain urinary incontinence (urge or stress). The concept of cognitive function highlights new ways of research to show the fundamental role of the cortex and the sub-cortex in these diseases.
METHODS: A comprehensive literature review using Pubmed, Medline, Embase and Cochrane: "cognition, urinary tract, urinary continence, neuroimaging, IRMf, micturition, urge, brain factor and cognitive therapy". In all the articles, 72 really dealt with micturition and cognition.
RESULTS: New imaging techniques allowed to show the relationship between the different brain area involved in the bladder control such as the periaqueductal gray, the hypothalamus, the insula, the anterior cingulated cortex and the prefrontal cortex. These cortical area are equally involved in cognition. An alteration of urinary continence implies a modification of activation of these cortical areas.
CONCLUSION: A better knowledge of the cognitive side of micturition and urinary continence will allow to improve the treatment of their associated diseases.
Written by:
Thubert T, Jousse M, Deffieux X, Amarenco G Are you the author?
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France; GREEN, groupe de recherche clinique en neuro-urologie, GRCUPMC01, 75020 Paris, France; Service de neuro-urologie et explorations périnéales, hôpital Tenon, groupe hospitalier EST, AP-HP, 75020 Paris, France. Electronic address:
(Article in French)
Reference: Prog Urol. 2013 Dec;23(17):1511-21 (Epub 2013 Sep 9)
doi: 10.1016/j.purol.2013.07.010
PubMed Abstract
PMID: 24286554
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