Skip main navigation

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)
© Association for Continence Advice. CC BY-NC 4.0

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.

© Association for Continence Advice. CC BY-NC 4.0
This article is from the free online

Understanding Continence Promotion: Effective Management of Bladder and Bowel Dysfunction in Adults

Created by
FutureLearn - Learning For Life

Our purpose is to transform access to education.

We offer a diverse selection of courses from leading universities and cultural institutions from around the world. These are delivered one step at a time, and are accessible on mobile, tablet and desktop, so you can fit learning around your life.

We believe learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.
You can unlock new opportunities with unlimited access to hundreds of online short courses for a year by subscribing to our Unlimited package. Build your knowledge with top universities and organisations.

Learn more about how FutureLearn is transforming access to education