Detrusor muscle

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Detrusor muscle
Illu bladder.jpg
Urinary bladder
Details
Origin Posterior surface of the body of the pubis
Insertion Prostate (male), vagina (female)
Artery Internal pudendal artery, inferior vesical artery
Nerve Sympathetic - hypogastric n. (T10-L2) Parasympathetic - pelvic splanchnic nerves (S2-4)
Actions Sympathetic relaxes, to store urine Parasympathetic contracts, to urinate
Identifiers
Latin musculus detrusor vesicae urinariae
TA98 A08.3.01.014
TA2 3413
FMA 68018
Anatomical terms of muscle

The detrusor muscle, also detrusor urinae muscle, muscularis propria of the urinary bladder and (less precise) muscularis propria , is smooth muscle found in the wall of the bladder. The detrusor muscle remains relaxed to allow the bladder to store urine, and contracts during urination to release urine. Related are the urethral sphincter muscles which envelop the urethra to control the flow of urine when they contract.

Contents

Structure

The fibers of the detrusor muscle arise from the posterior surface of the body of the pubis in both sexes (musculi pubovesicales), and in the male from the adjacent part of the prostate. These fibers pass, in a more or less longitudinal manner, up the inferior surface of the bladder, over its apex, and then descend along its fundus to become attached to the prostate in the male, and to the front of the vagina in the female. At the sides of the bladder the fibers are arranged obliquely and intersect one another.

The three layers of muscles are arranged longitudinal-circular-longitudinal from innermost to outermost.

Nerve supply

The detrusor muscle is innervated by the autonomic nervous system.

During urination, parasympathetic pelvic splanchnic nerves act primarily on postganglionic M3 receptors to cause contraction of the detrusor muscle. [1] [2] [3]

At other times, the muscle is kept relaxed via sympathetic branches from the inferior hypogastric plexus to allow the bladder to fill. [4]

Clinical significance

In older adults over 60 years in age, the detrusor muscle may cause issues in voiding the bladder, resulting in uncomfortable urinary retention. [5]

The bladder also contains β3 adrenergic receptors, and pharmacological agonists of this receptor are used to treat overactive bladder.

The mucosa of the urinary bladder may herniate through the detrusor muscle. [6] This is most often an acquired condition due to high pressure in the urinary bladder, damage, or existing connective tissue disorders. [6]

See also


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References

  1. "Bladder: Pharmacology of the detrusor receptors". www.urology-textbook.com. Retrieved 2024-06-07.
  2. Sellers, Donna J.; Chess-Williams, Russ (2012). "Muscarinic agonists and antagonists: effects on the urinary bladder". Handbook of Experimental Pharmacology (208): 375–400. doi:10.1007/978-3-642-23274-9_16. ISSN   0171-2004. PMID   22222707.
  3. Giglio, Daniel; Tobin, Gunnar (2009). "Muscarinic receptor subtypes in the lower urinary tract". Pharmacology. 83 (5): 259–269. doi:10.1159/000209255. ISSN   1423-0313. PMID   19295256.
  4. Ho, MAT H.; Bhatia, NARENDER N. (2007-01-01), Lobo, Rogerio A. (ed.), "CHAPTER 51 - Lower Urinary Tract Disorders in Postmenopausal Women", Treatment of the Postmenopausal Woman (Third Edition), St. Louis: Academic Press, pp. 693–737, ISBN   978-0-12-369443-0 , retrieved 2021-02-05
  5. Stoffel, JT (September 2017). "Non-neurogenic Chronic Urinary Retention: What Are We Treating?". Current Urology Reports. 18 (9): 74. doi:10.1007/s11934-017-0719-2. PMID   28730405. S2CID   12989132.
  6. 1 2 Merrow, A. Carlson; Hariharan, Selena, eds. (2018-01-01), "Bladder Diverticula", Imaging in Pediatrics, Elsevier, p. 205, doi:10.1016/b978-0-323-47778-9.50153-7, ISBN   978-0-323-47778-9 , retrieved 2021-02-05