Pharmacology of the urinary tract

The urinary tract conveys urine via the ureter to the bladder, where it is stored and periodically expelled. Dysfunction of the urinary tract ranges from bladder overactivity, due to outflow tract obstruction, neuropathic causes or an idiopathic condition, to renal colic often arising from the accumulation of stones. The management of such conditions with drugs and other regimens requires knowledge of the pharmacology of different tissues within the tract. This article examines how such knowledge has been used to regulate the sensory and contractile functions of the tract through currently used agents, and also considers potentially useful targets for future drug development. Particular targets include the urothelium, sensory and motor nerves, and smooth muscle of the bladder; the bladder outflow tract; the prostate; CNS components that regulate the micturition reflex; and the outflow tract. Evaluation of particular differences in the pharmacological control of each component increases the chance that useful therapeutic agents may be developed to target particular dysfunctions, while leaving normal function intact.