CA1

What two nerves are responsible for the storage phase (involuntary) and state their purpose?

• Hypogastric: Detrusor muscle relaxation (b1 adrenergic receptors) and internal sphincter contraction (a1 adrenergic receptors)

• Pudendal: external sphincter contraction

What nerve is responsible for micturition in the voiding phase?

• Pelvic: Detrusor muscle contraction (ACh-m)

What are some Non-Neurogenic Storage disorders?

• Urethral Sphincter Mechanism Incompetence

• Ectopic Ureters

What are some Neurogenic Storage Disorders?

• Sacro-caudal spinal cord disease

What are some Non-neurogenic Voiding Disorders

• Functional Outflow Obstruction

• Mechanical Outflow Obstruction

• Atonic Bladder

• Bladder Fibrosis

What are some Neurogenic Voiding Disorders?

• Lesions cranial to the S1 spinal cord segment

What is USMI typically associated with?

• Neutering

• Altered sex hormones

What are some differentials to rule out USMI?

• Abdominal ultrasound

• Urinalysis

• Urine culture

• Measure post-void residual volume

State the purpose of some drugs used to manage USMI?

• Phenylpropanolamine: a1 adrenergic agonist- tighten internal sphincter; 28-day treatment trial

• Diethylstilbestrol/Estriol: a1 adrenergic receptor

• Testosterone Cypionate

• Urethral Bulking agents: Collagen injections

What is the pathophysiology of Ectopic Ureters?

Congenital malposition of the ureters bypassing the trigone.

State the difference between Intramural and Extramural Ectopic Ureters.

• Intramural: