Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Apr;44(4):935-943.
doi: 10.1002/nau.70003. Epub 2025 Mar 19.

Advancing our Understanding of the Urothelium and Lamina Propria, Hormone Receptors, Vascular Supply, and Sensory Aspects of the Female Human Urethra

Margaret Mueller  1 , Bernard T Drumm  2 , Johanna L Hannan  3 , Hannah Ruetten  4   5
Affiliations
Review

Advancing our Understanding of the Urothelium and Lamina Propria, Hormone Receptors, Vascular Supply, and Sensory Aspects of the Female Human Urethra

Margaret Mueller et al. Neurourol Urodyn. 2025 Apr.

Abstract

Objective: Urinary continence is important for women's health and wellbeing. The female urethra has been understudied and mechanisms of continence remain poorly understood. Our objective is to provide a summary of current knowledge of the epithelium and lamina propria, hormone receptors, vascular supply, and sensory aspects of the female urethra and highlight continued gaps in knowledge.

Methods: In October of 2020, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) sponsored a virtual seminar series entitled "Female Urethral Function and Failure: Advancing Basic and Translational Research for Genitourinary Conditions". We summarize the information presented during session 3 presentations, provide additional information from recent studies, and highlight continued gaps in knowledge.

Results: A sensory role for urethral mucosa seems apparent based on the dense innervation of sensory afferent neurons but how the sensory afferents contribute to continence remains poorly understood. There is a complex relationship with behavior that comes into play when evaluating the contribution of sex hormones to urinary physiology. We need to update our understanding of where hormone receptors are located in the female urinary tract. Many causes of impaired urethral blood flow are also common risk factors for urinary dysfunction but we don't know how vasculature contributes to continence. Altered afferent urethral function has been implicated in several disease states, but is largely understudied.

Conclusion: There is much that remains to be learned about the urothelium and lamina propria, expression and influence of sex hormones and hormone receptors, vascular supply, and sensory aspects of the female urethra.

Trial registration: No new data was generated for this manuscript, no clinical trial was conducted, and therefore clinical trial registration was not necessary.

Keywords: estrogen; micturition; stress urinary incontinence; urge urinary incontinence; urinary incontinence; urinary tract.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest disclosure: No conflicts of interest, financial or otherwise, are declared by the author(s).

References

    1. Huisman AB. Aspects on the anatomy of the female urethra with special relation to urinary continence. Contrib Gynecol Obstet. 1983;10:1–31. - PubMed
    1. Rud T, Andersson KE, Asmussen M, Hunting A, Ulmsten U. Factors maintaining the intraurethral pressure in women. Invest Urol. Jan 1980;17(4):343–7. - PubMed
    1. Attari A, DeLancey JO, Ashton-Miller JA. On Structure-Function Relationships in the Female Human Urethra: A Finite Element Model Approach. Ann Biomed Eng. Aug 2021;49(8):1848–1860. doi:10.1007/s10439-021-02765-4 - DOI - PMC - PubMed
    1. Pipitone F, Sadeghi Z, DeLancey JOL. Urethral function and failure: A review of current knowledge of urethral closure mechanisms, how they vary, and how they are affected by life events. Neurourol Urodyn. Nov 2021;40(8):1869–1879. doi:10.1002/nau.24760 - DOI - PMC - PubMed
    1. Keane DP, O’Sullivan S. Urinary incontinence: anatomy, physiology and pathophysiology. Baillieres Best Pract Res Clin Obstet Gynaecol. Apr 2000;14(2):207–26. doi:10.1053/beog.1999.0072 - DOI - PubMed

LinkOut - more resources