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November 25, 1961

Voiding, Its Mechanism

JAMA. 1961;178(8):847-848. doi:10.1001/jama.1961.73040470025015c
Abstract

MICTURITION has been studied extensively over the years, but prior to the work of Muellner the autonomic nervous system was considered the keystone of urinary control. Muellner showed that the voluntary muscles of the perineum were basically responsible for the voluntary act of miction and urinary continence. The ability to voluntarily relax the perineal muscles was essential to initiate urination, and the normal tone of the pelvic diaphragm was necessary for urinary continence. We have no divergent views, but present these studies to substantiate Muellner's observations.

We have recorded cinefluorographically the role of the striated extravesical musculature in both normal and abnormal states of micturition. These photographic records confirm the fact that pelvoperineal musculature plays the principal part in voluntary urinary control, with the external urinary sphincter being concerned but momentarily.

The voluntary muscles of micturition are the levator and the sphincter urethral and the bulbocarvernosis (in the male).

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