{"id":1434,"date":"2025-05-26T09:28:50","date_gmt":"2025-05-26T09:28:50","guid":{"rendered":"https:\/\/urolistic.com\/?p=1434"},"modified":"2025-05-27T08:05:42","modified_gmt":"2025-05-27T08:05:42","slug":"como-funciona-el-sistema-urinario","status":"publish","type":"post","link":"https:\/\/urolistic.com\/es\/blog\/2025\/05\/26\/como-funciona-el-sistema-urinario\/","title":{"rendered":"\u00bfC\u00f3mo funciona el sistema\u00a0 urinario?"},"content":{"rendered":"\t\t
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Una vez la orina es producida en los ri\u00f1ones y recogida por los c\u00e1lices y la\u00a0 pelvis renal, \u00e9sta desciende por los ur\u00e9teres hasta la vejiga. Los ur\u00e9teres\u00a0 son unos tubos muy finos, de unos 5 mm de di\u00e1metro, que tienen\u00a0 movimientos perist\u00e1lticos (como los del intestino) que permiten a la orina\u00a0 avanzar m\u00e1s f\u00e1cilmente. Una vez llegada a la vejiga, la orina queda\u00a0 almacenada en ella hasta que es expulsada durante la micci\u00f3n.<\/p>\n

\u00a0El funcionamiento de la vejiga es muy complejo, pues depende de tres\u00a0 tipos de nervios diferentes, a saber: el nervio hipog\u00e1strico perteneciente al\u00a0 sistema nervioso simp\u00e1tico, el nervio p\u00e9lvico perteneciente al\u00a0 parasimp\u00e1tico y el nervio pudendo perteneciente al sistema nervioso\u00a0 voluntario o som\u00e1tico. El sistema nervioso simp\u00e1tico y el parasimp\u00e1tico\u00a0 pertenecen al sistema nervioso aut\u00f3nomo, que tal y como su nombre\u00a0 indica, es un sistema nervioso que no est\u00e1 bajo el control voluntario del\u00a0 cerebro. No es el objetivo de este art\u00edculo explicar detalladamente el\u00a0 complejo reflejo de la micci\u00f3n, destacar\u00e9 \u00fanicamente que todos estos\u00a0 nervios parten de n\u00facleos de neuronas que se encuentran en la m\u00e9dula\u00a0 espinal (T11-L2 para el nervio hipog\u00e1strico, S2-S4 para el nervio p\u00e9lvico y\u00a0 para el pudendo), que a su vez est\u00e1n regulados por estructuras cerebrales\u00a0 superiores. De tal manera, que se puede\u00a0 imaginar que cuando hay problemas en la columna vertebral (una hernia de\u00a0 disco por ejemplo) o existe una enfermedad neurol\u00f3gica (como por\u00a0 ejemplo la enfermedad de Parkinson, Alzheimer, la esclerosis m\u00faltiple o un\u00a0 ICTUS, entre muchas otras) el reflejo de la micci\u00f3n puede verse afectado.\u00a0 En condiciones normales, el trabajo coordinado de estos tres sistemas\u00a0 nerviosos es fundamental para que tanto la micci\u00f3n como la continencia\u00a0 ocurran de manera adecuada. As\u00ed, durante la micci\u00f3n debe producirse una\u00a0 contracci\u00f3n del m\u00fasculo detrusor de la vejiga gracias al impulso nervioso\u00a0 que recibe de las fibras parasimp\u00e1ticas, al mismo tiempo que el cuello\u00a0 vesical (o esf\u00ednter interno) y el esf\u00ednter externo se relajan, el primero\u00a0 gobernado por las fibras simp\u00e1ticas y el segundo por las fibras som\u00e1ticas\u00a0 del nervio pudendo. Si esta coordinaci\u00f3n no se produce adecuadamente,\u00a0 ocurrir\u00e1 una micci\u00f3n disin\u00e9rgica o micci\u00f3n no coordinada, con\u00a0 contracciones de uno o de los dos esf\u00ednteres durante el vaciado, un\u00a0 vaciado vesical incompleto, o las dos cosas a la vez. Fuera de las\u00a0 micciones, el m\u00fasculo detrusor est\u00e1 en reposo gracias a que existe un alto tono simp\u00e1tico y un bajo tono parasimp\u00e1tico que permite relajar sus fibras\u00a0 y dar capacidad a la vejiga. Al mismo tiempo, el cuello vesical est\u00e1\u00a0 contra\u00eddo gracias al simp\u00e1tico tambi\u00e9n y el esf\u00ednter externo contra\u00eddo\u00a0 gracias a la acci\u00f3n del nervio pudendo. Esta situaci\u00f3n nos permite ser continentes y no perder la orina mientras la\u00a0 vejiga se est\u00e1 llenando.<\/p>\n

\u00a0Habiendo visto esto, podemos comprender que cualquier obstrucci\u00f3n a\u00a0 la salida de la orina, ya sea de origen anat\u00f3mico (hipertrofia de la pr\u00f3stata,\u00a0 estenosis cicatricial o cong\u00e9nita de la uretra) o de origen funcional por la\u00a0 cual no se relajan bien los esf\u00ednteres al orinar (micci\u00f3n no coordinada,\u00a0 disinergia de causa neurol\u00f3gica), puede\u00a0 favorecer las infecciones de orina,\u00a0 al igual que cualquier enfermedad que provoque una debilidad del m\u00fasculo\u00a0 de la vejiga que no permita que \u00e9ste expulse correctamente la orina,\u00a0 aunque no haya ninguna obstrucci\u00f3n.\u00a0<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Arponen S (2021).\u00a0Es la microbiota, idiota<\/em>. Alienta.<\/p>\n

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Godaly G, Ambite I, Svanborg C. Innate immunity and genetic determinants of urinary tract infection susceptibility. Curr Opin Infect Dis. 2015 Feb;28(1):88-96.<\/p>\n

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Lacerda Mariano L, Ingersoll MA. Bladder resident macrophages: Mucosal sentinels. Cell Immunol. 2018 Aug;330:136-141.\u00a0<\/p>\n

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Song J, Abraham SN. TLR-mediated immune responses in the urinary tract. Curr Opin Microbiol. 2008 Feb;11(1):66-73.<\/p>\n

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Becknell B, Ching C, Spencer JD. The Responses of the Ribonuclease A Superfamily to Urinary Tract Infection. Front Immunol. 2019 Nov 29;10:2786.<\/p>\n

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Steigedal M, Marstad A, Haug M, Dam\u00e5s JK, Strong RK, et al. Lipocalin 2 imparts selective pressure on bacterial growth in the bladder and is elevated in women with urinary tract infection. J Immunol. 2014 Dec 15;193(12):6081-9.<\/p>\n

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Ueda N, Kondo M, Takezawa K, Kiuchi H, Sekii Y, et al. Bladder urothelium converts bacterial lipopolysaccharide information into neural signaling via an ATP-mediated pathway to enhance the micturition reflex for rapid defense. Sci Rep. 2020 Dec 3;10(1):21167.\u00a0<\/p>\n

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Hayes BW, Abraham SN. Innate Immune Responses to Bladder Infection. Microbiol Spectr. 2016 Dec;4(6):10.1128\/microbiolspec.UTI-0024-2016.\u00a0<\/p>\n

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O\u2019Brien VP, Hannan TJ, Schaeffer AJ, Hultgren SJ. Are you experienced? Understanding bladder innate immunity in the context of recurrent urinary tract infection. Curr Opin Infect Dis. 2015 Feb;28(1):97-105.<\/p>\n

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Huang J, Fu L, Huang J, Zhao J, Zhang X, et al. Group 3 Innate Lymphoid Cells Protect the Host from the Uropathogenic Escherichia coli Infection in the Bladder. Adv Sci (Weinh). 2022 Feb;9(6):e2103303.<\/p>\n

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Wu J, Abraham SN. The Roles of T cells in Bladder Pathologies. Trends Immunol. 2021 Mar;42(3):248-260.\u00a0<\/p>\n

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Billips BK, Schaeffer AJ, Klumpp DJ. Molecular basis of uropathogenic Escherichia coli evasion of the innate immune response in the bladder. Infect Immun. 2008 Sep;76(9):3891-900.<\/p>\n

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Nielsen KL, Stegger M, Kiil K, Godfrey PA, Feldgarden M, Lilje B, Andersen PS, Frimodt-M\u00f8ller N. Whole-genome comparison of urinary pathogenic Escherichia coli and faecal isolates of UTI patients and healthy controls. Int J Med Microbiol. 2017 Dec;307(8):497-507.\u00a0<\/p>\n

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Ambite I, Butler D, Wan MLY, Rosenblad T, Tran TH, Chao SM, Svanborg C. Molecular determinants of disease severity in urinary tract infection. Nat Rev Urol. 2021 Aug;18(8):468-486.<\/p>\n

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Ziegler T, Jacobsohn N, F\u00fcnfst\u00fcck R. Correlation between blood group phenotype and virulence properties of Escherichia coli in patients with chronic urinary tract infection. Int J Antimicrob Agents. 2004 Sep;24 Suppl 1:S70-5.<\/p>\n

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Sulaiman KA, Al Qahtani N, Al Muqrin M, Al Dossari M, Al Wabel A, et al. The correlation between non-O blood group type and recurrent catheter-associated urinary tract infections in critically ill patients: A retrospective study. J Int Med Res. 2022 Jul;50(7):3000605221108082.\u00a0<\/p>\n

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Albracht CD, Hreha TN, Hunstad DA. Sex effects in pyelonephritis. Pediatr Nephrol. 2021 Mar;36(3):507-515.\u00a0<\/p>\n

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Wnorowska U, Piktel E, Deptu\u0142a P, Wollny T, Kr\u00f3l G, et al. Ceragenin CSA-13 displays high antibacterial efficiency in a mouse model of urinary tract infection. Sci Rep. 2022 Nov 10;12(1):19164.<\/p>\n

<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Una vez la orina es producida en los ri\u00f1ones y recogida por los c\u00e1lices y la\u00a0 pelvis renal, \u00e9sta desciende por los ur\u00e9teres hasta la vejiga. [\u2026]<\/span><\/p>\n","protected":false},"author":1,"featured_media":1536,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-1434","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-salud-urologica"],"yoast_head":"\n\u00bfC\u00f3mo funciona el sistema\u00a0 urinario? | Urolistic<\/title>\n<meta name=\"description\" content=\"Redescubre el bienestar con Urolistic, el proyecto de la Dra. 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