Sex differences in lower urinary tract biology and physiology

Benjamin Abelson, Daniel Sun, Lauren Que, Rebecca A. Nebel, Dylan Baker, Patrick Popiel, Cindy L. Amundsen, Toby Chai, Clare Close, Michael Disanto, Matthew O. Fraser, Stephanie J. Kielb, George Kuchel, Elizabeth R. Mueller, Mary H. Palmer, Candace Parker-Autry, Alan J. Wolfe, Margot S. Damaser*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations


Females and males differ significantly in gross anatomy and physiology of the lower urinary tract, and these differences are commonly discussed in the medical and scientific literature. However, less attention is dedicated to investigating the varied development, function, and biology between females and males on a cellular level. Recognizing that cell biology is not uniform, especially in the lower urinary tract of females and males, is crucial for providing context and relevance for diverse fields of biomedical investigation. This review serves to characterize the current understanding of biological sex differences between female and male lower urinary tracts, while identifying areas for future research. First, the differences in overall cell populations are discussed in the detrusor smooth muscle, urothelium, and trigone. Second, the urethra is discussed, including anatomic discussions of the female and male urethra followed by discussions of cellular differences in the urothelial and muscular layers. The pelvic floor is then reviewed, followed by an examination of the sex differences in hormonal regulation, the urinary tract microbiome, and the reticuloendothelial system. Understanding the complex and dynamic development, anatomy, and physiology of the lower urinary tract should be contextualized by the sex differences described in this review.

Original languageEnglish (US)
Article number45
JournalBiology of Sex Differences
Issue number1
StatePublished - Oct 22 2018


  • Cell biology
  • Lower urinary tract
  • Sex differences
  • Urology

ASJC Scopus subject areas

  • Gender Studies
  • Endocrinology


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