{"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\/fr\/blog\/2025\/05\/26\/como-funciona-el-sistema-urinario\/","title":{"rendered":"Comment fonctionne le syst\u00e8me urinaire ?"},"content":{"rendered":"
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Une fois que l'urine est produite dans les reins et collect\u00e9e par les calices et le bassinet, elle s'\u00e9coule dans les uret\u00e8res jusqu'\u00e0 la vessie. Les uret\u00e8res sont des tubes tr\u00e8s fins, d'environ 5 mm de diam\u00e8tre, qui ont des mouvements p\u00e9ristaltiques (comme ceux de l'intestin) qui permettent \u00e0 l'urine de se d\u00e9placer plus facilement. Une fois qu'elle a atteint la vessie, l'urine est stock\u00e9e dans la vessie jusqu'\u00e0 ce qu'elle soit expuls\u00e9e lors de la miction.<\/p>\n

\u00a0Le fonctionnement de la vessie est tr\u00e8s complexe, car il d\u00e9pend de trois types de nerfs diff\u00e9rents, \u00e0 savoir le nerf hypogastrique appartenant au syst\u00e8me nerveux sympathique, le nerf pelvien appartenant au parasympathique et le nerf pudendal appartenant au syst\u00e8me nerveux volontaire ou somatique. Les syst\u00e8mes nerveux sympathique et parasympathique appartiennent au syst\u00e8me nerveux autonome qui, comme son nom l'indique, est un syst\u00e8me nerveux qui n'est pas sous le contr\u00f4le volontaire du cerveau. Le but de cet article n'est pas d'expliquer en d\u00e9tail le r\u00e9flexe complexe de la miction, je me contenterai de rappeler que tous ces nerfs partent de noyaux de neurones situ\u00e9s dans la moelle \u00e9pini\u00e8re (T11-L2 pour le nerf hypogastrique, S2-S4 pour le nerf pelvien et pour le nerf pudendal), qui sont \u00e0 leur tour r\u00e9gul\u00e9s par des structures c\u00e9r\u00e9brales sup\u00e9rieures. On peut donc imaginer qu'en cas de probl\u00e8mes au niveau de la colonne vert\u00e9brale (hernie discale par exemple) ou de maladie neurologique (comme la maladie de Parkinson, la maladie d'Alzheimer, la scl\u00e9rose en plaques ou un accident vasculaire c\u00e9r\u00e9bral, entre autres), le r\u00e9flexe de miction peut \u00eatre affect\u00e9. Dans des conditions normales, le travail coordonn\u00e9 de ces trois syst\u00e8mes nerveux est essentiel pour que la miction et la continence se d\u00e9roulent correctement. Ainsi, lors de la miction, le muscle d\u00e9trusor de la vessie doit se contracter gr\u00e2ce \u00e0 l'influx nerveux qu'il re\u00e7oit des fibres parasympathiques, tandis que le col v\u00e9sical (ou sphincter interne) et le sphincter externe se rel\u00e2chent, le premier \u00e9tant r\u00e9gi par les fibres sympathiques et le second par les fibres somatiques du nerf pudendal. Si cette coordination ne se fait pas correctement, il y a miction dyssynergique ou miction dysfonctionnelle, avec des contractions de l'un ou des deux sphincters pendant la miction, une vidange incompl\u00e8te de la vessie, ou les deux \u00e0 la fois. En dehors de la miction, le muscle d\u00e9trusor est au repos en raison d'un tonus sympathique \u00e9lev\u00e9 et d'un tonus parasympathique faible, ce qui permet \u00e0 ses fibres de se d\u00e9tendre et de donner de la capacit\u00e9 \u00e0 la vessie. En m\u00eame temps, le col de la vessie est contract\u00e9 gr\u00e2ce au tonus sympathique et le sphincter externe est contract\u00e9 gr\u00e2ce \u00e0 l'action du nerf pudendal. Cette situation nous permet d'\u00eatre continent et de ne pas perdre d'urine pendant que la vessie se remplit.<\/p>\n

\u00a0On comprend alors que tout obstacle \u00e0 l'\u00e9coulement de l'urine, qu'il soit d'origine anatomique (hypertrophie de la prostate, st\u00e9nose cicatricielle ou cong\u00e9nitale de l'ur\u00e8tre) ou d'origine fonctionnelle par un mauvais rel\u00e2chement des sphincters lors de la miction (miction dysfonctionnelle, dyssynergie d'origine neurologique), peut favoriser les infections urinaires, de m\u00eame que toute maladie entra\u00eenant une faiblesse du muscle de la vessie qui ne lui permet pas d'expulser correctement l'urine, m\u00eame en l'absence d'obstruction.\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

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Une fois que l'urine est produite dans les reins et collect\u00e9e par les calices et le bassinet, elle s'\u00e9coule dans les uret\u00e8res jusqu'\u00e0 la vessie. [...]<\/span><\/p>","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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