Which control centres in the body work together to control urination?

The spinal, cortical and pontine micturition control centres all work together to control micturition (urination). Find out what happens when there is damage to the micturation control centres.

1. Spinal micturition control centre

The spinal micturition control centre is between S2-S4 in the spinal cord. The spinal micturition control centre relays sensory information from the bladder and outgoing motor nerve impulses.

2. Pontine micturition control centre

The pontine micturition control centre is in the brain stem. It is responsible for the co-ordination of the sphincter relaxation and the detrusor contraction. It works like a ‘switch’ controlling storage and voiding.

3. Cortical micturition control centre

The cortical micturition control centre is in the frontal cortex. The cortical micturition control centre inhibits the spinal reflex arc during the filling cycle.

Complete voluntary control is not usually achieved until 3-4 years of age and may be later.

Damage to micturition control centres

So, what can happen if there is damage to these micturition control centres?

The spinal micturition control centre is positioned low down in the spinal cord and any damage to the spinal cord above this S2-S4 level can affect the control of micturition. People with spinal cord damage often experience a reflex bladder which empties spontaneously.

Damage to the pontine micturition control centre can affect the co-ordination of the sphincter relaxation and detrusor contraction, this condition is known as dyssynergia. With dyssynergia there is a desire to void but the individual is not able to pass urine, due to a lack of co-ordination and this results in incomplete bladder emptying.

Lesions affecting the cortical micturition control centre can remove the cortical inhibition and result in increased bladder activity causing urgency and frequency.