How does the lower urinary tract contribute to bladder sensation? ICI-RS 2023

Luke Grundy, Jean J. Wyndaele, Hikaru Hashitani, Bahareh Vahabi, Alan Wein, Paul Abrams, Basu Chakrabarty, Christopher H. Fry

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)
33 Downloads (Pure)


Aim: Bladder sensation is critical for coordinating voluntary micturition to maintain healthy bladder function. Sensations are initiated by the activation of sensory afferents that innervate throughout the bladder wall. However, the physiological complexity that underlies the initiation of bladder sensory signaling in health and disease remains poorly understood. This review summarises the latest knowledge of the mechanisms underlying the generation of bladder sensation and identifies key areas for future research. 

Methods: Experts in bladder sensory signaling reviewed the literature on how the lower urinary tract contributes to bladder sensation and identified key research areas for discussion at the 10th International Consultation on Incontinence—Research Society. 

Results: The importance of bladder sensory signals in maintaining healthy bladder function is well established. However, better therapeutic management of bladder disorders with exaggerated bladder sensation, including overactive bladder syndrome (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS) is limited by a lack of knowledge in a number of key research areas including; the contribution of different nerves (pudendal, pelvic, hypogastric) to filling sensations in health and disease; the relative contribution of stretch sensitive (muscular) and stretch-insensitive (mucosal) afferents to bladder sensation in health and disease; the direct and indirect contributions of the muscularis mucosae to bladder contraction and sensation; and the impact of manipulating urothelial release factors on bladder sensation. 

Conclusion: Disturbances in bladder sensory signaling can have severe consequences for bladder sensation and function including the development of OAB and IC/BPS. Advancing therapeutic treatments for OAB and IC/BPS requires a deeper understanding of the mechanisms underlying the generation of bladder sensation, and key areas for future research have been identified.

Original languageEnglish
Pages (from-to)1293-1302
Number of pages10
JournalNeurourology and Urodynamics
Issue number6
Early online date30 Oct 2023
Publication statusE-pub ahead of print - 30 Oct 2023


  • afferent
  • bladder
  • hypersensitivity
  • muscularis mucosae
  • nitric oxide
  • sensation
  • urothelium


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