How Your Body Knows When You Have to Pee

Definition

Urinary Incontinence

Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled urine leakage. There are four main types of urinary incontinence:

• Urge incontinence due to an overactive bladder.
• Mixed incontinence involving features of different other types.
• Overflow incontinence due to either poor bladder contraction or blockage of the urethra.
• Stress incontinence due to a poorly functioning urethral sphincter muscle (intrinsic sphincter deficiency), hypermobility of the bladder neck, or urethra.

The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis (bed wetting).

Main Digest

Got to go? Harvard scientists figure out how your body knows when it's time to pee. New research in the FASEB Journal shows that the epithelium layer in the bladder is able to sense bladder fullness through the activity of integrins.

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(UI), involuntary urination, or enuresis is any involuntary leakage of urine. It can be a common and distressing problem, which may have a profound impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but is under-reported to medical practitioners. It is a very common problem and is thought to affect millions of people worldwide.

If you have an over-active bladder or incontinence, help could be on the way.

A new research report published online in the FASEB Journal, shows that the epithelium, a thin layer of cells which line the surface of the bladder, is able to sense how full the bladder is through the action of a family of proteins called integrins. As the bladder becomes full, the cells in the epithelium stretch and become thinner, which activates the integrins to send that information to nerves and other cells in the bladder. As a result of this new knowledge, researchers may one day be able to design drugs that target this mechanism to treat conditions like incontinence and over-active bladder, both of which are common, serious, problems affecting millions of people.

"I am very hopeful that as we learn more about how the bladder senses fullness and conveys that information to the nerves and the muscles which control our ability to urinate, that this greater understanding and knowledge will lead to new treatments," said Warren G. Hill, Ph.D., a researcher involved in the work from the Department of Medicine at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, MA.

"It is extremely important that we do this as quickly as possible, since there are millions of people who suffer enormously from the anguish of bladder pain, incontinence and constant feelings of needing to go. I am optimistic these new insights into the role of integrins will begin the process of discovering important new drug targets which will dramatically improve the quality of life for many of these people."

To make this discovery, Hill and colleagues tested two groups of mice.

The first were genetically modified to not have an important member of the integrin family present in the epithelium.

The second group of mice was normal.

The mice lacking the integrin protein had normal looking bladders but very little urinary control.

The normal mice also had normal looking bladders, but as expected, had bladder control.

Researchers then tested the bladders from the integrin knockout mice and found that their bladders were constantly squeezing and very over-active. In addition, they overfilled their bladders and took much longer to urinate than the normal mice. Since most drug treatments for over-active bladder target proteins in the muscle surrounding the bladder, this study shows that it may be possible to design drugs that target sensory proteins in the epithelium.

"No one wants to pee in his or her pants," said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, "but the reality is that bladder problems - incontinence, frequency and pain - affect more people than we realize. This report offers hope that new drugs targeting the bladder's epithelium will succeed when current drugs fail."

FASEB Journal

The FASEB Journal is published by the Federation of the American Societies for Experimental Biology (FASEB). It is among the most cited biology journals worldwide according to the Institute for Scientific Information and has been recognized by the Special Libraries Association as one of the top 100 most influential biomedical journals of the past century. FASEB is composed of 26 societies with more than 100,000 members, making it the largest coalition of biomedical research associations in the United States. Its mission is to advance health and welfare by promoting progress and education in biological and biomedical sciences through service to its member societies and through collaborative advocacy.

Keizo Kanasaki, Weiqun Yu, Maximilian von Bodungen, John D. Larigakis, Megumi Kanasaki, Francisco Ayala de la Pena, Raghu Kalluri, and Warren G. Hill. Loss of β1-integrin from urothelium results in over-active bladder and incontinence in mice: a mechanosensory rather than structural phenotype. FASEB J doi:10.1096/fj.12-223404 ; www.fasebj.org/content/early/2013/02/08/fj.12-223404.abstract

Resources That Provide Relevant Information

• Women with Urinary Incontinence May Get Relief from Yoga
• Urine Colors Chart: Meaning of Pee Color, Smell and Consistency
• Male Kegel Exercises Help Urinary Incontinence
• Stress Urinary Incontinence Affects 1 in 3 Women
• Yoga of Immortals App for Urinary Incontinence
• Incontinence: Types and General Information
• Urinary Incontinence Impact on Quality of Life

Attribution/Source(s):

This peer reviewed article relating to our Health and Disability section was selected for publishing by the editors of Disabled World due to its likely interest to our disability community readers. Though the content may have been edited for style, clarity, or length, the article "How Your Body Knows When You Have to Pee" was originally written by Federation of American Societies for Experimental Biology, and published by Disabled-World.com on 2013-02-10 (Updated: 2022-07-26). Should you require further information or clarification, Federation of American Societies for Experimental Biology can be contacted at fasebj.org. Disabled World makes no warranties or representations in connection therewith.

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