Bladder afferent hyperexcitability in bladder pain syndrome/interstitial cystitis

Abstract

Bladder pain syndrome/interstitial cystitis is a disease with lower urinary tract symptoms, such as bladder pain and urinary frequency, which results in seriously impaired quality of life of patients. The extreme pain and urinary frequency are often difficult to treat. Although the etiology of bladder pain syndrome/interstitial cystitis is still not known, there is increasing evidence showing that afferent hyperexcitability as a result of neurogenic bladder inflammation and urothelial dysfunction is important to the pathophysiological basis of symptom development. Further investigation of the pathophysiology will lead to the effective treatment of patients with bladder pain syndrome/interstitial cystitis.

Keywords: afferent pathway; bladder pain syndrome; cytokine; interstitial cystitis; nerve growth factor.

Fig. 1

Proposed pathogenesis of BPS/IC.

Fig. 2

Summary of the events involved in chronic inflammation of the bladder and hyperexcitability of C-fiber bladder afferent pathways. The events that occur after chronic bladder inflammation (1) are shows in sequential numbers (2–5). Potential therapeutic modalities targeting enhanced synaptic transmission at the spinal cord level or inflammatory changes in the bladder are also shown in the boxes.