The physiology and pharmacology of the lower urinary tract

The lower urinary tract consists of the bladder and urethra in both sexes, and the prostate additionally in men and is concerned with the storage of urine and its voluntary and controlled expulsion from the body when socially convenient. These mutually exclusive states are mediated by complex neural networks that when dysfunctional may generate bothersome and prevalent lower urinary tract symptoms (LUTS). These symptoms are often idiopathic and not pathology specific. Most may be caused by bladder outflow obstruction, disorders of bladder contractility or conditions which increase bladder sensitivity and a combination of any of these states. Despite the precise mechanisms of symptom generation remaining unclear, the receptor mechanisms involved in controlling lower urinary tract function can be pharmacologically manipulated to achieve useful clinical outcomes.