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Review
. 2015 Apr;16(2):265-84.
doi: 10.1007/s10522-015-9554-3. Epub 2015 Feb 11.

Neurogenic mechanisms in bladder and bowel ageing

Richard N Ranson  1 , M Jill Saffrey
Affiliations
Review

Neurogenic mechanisms in bladder and bowel ageing

Richard N Ranson et al. Biogerontology. 2015 Apr.

Abstract

The prevalence of both urinary and faecal incontinence, and also chronic constipation, increases with ageing and these conditions have a major impact on the quality of life of the elderly. Management of bladder and bowel dysfunction in the elderly is currently far from ideal and also carries a significant financial burden. Understanding how these changes occur is thus a major priority in biogerontology. The functions of the bladder and terminal bowel are regulated by complex neuronal networks. In particular neurons of the spinal cord and peripheral ganglia play a key role in regulating micturition and defaecation reflexes as well as promoting continence. In this review we discuss the evidence for ageing-induced neuronal dysfunction that might predispose to neurogenic forms of incontinence in the elderly.

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Figures

Fig. 1
Fig. 1
A 45 μm section of osmicated mouse spinal cord taken from spinal levels L5–S1. At this level groups of neurons that provide the parasympathetic innervation of bladder and bowel are located in the sacral parasympathetic nucleus (SPN). Sited more ventrally are motoneurons contained within the dorsolateral nucleus (DLN) and spinal nucleus of the bulbospongiosus (SNB) that provide axons to the pudendal nerve. A proportion of motoneurons in the DLN/SNB provide innervation of the external anal and urethral sphincters and the levator ani muscle and are involved in maintaining urinary and faecal continence. Scale bar 250 μm
Fig. 2
Fig. 2
Anal sphincter region of mouse gut a stained with haematoxylin and eosin, and b immunolabelled with antiserum against the pan-neuronal marker PGP9.5. CM circular muscle (IAS), LM longitudinal muscle, MPl myenteric plexus, Muc mucosa, SkM skeletal muscle of the external anal sphincter. Scale bars represent 100 μm
See this image and copyright information in PMC

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