Chronic bladder pain (CBP) patients present with pelvic pain or discomfort during bladder filling, for at least a period of 6 months, which may be accompanied by lower urinary tract symptoms such as frequency, nocturia, and urgency.
However, both the etiology of CBP and pathophysiological mechanisms are not well described. A number of clinical and basic animal model findings support involvement of sympathetic nervous system in chronic pain syndromes such as CBP. Examples include sympathetic overactivity and high plasma or urinary catecholamine levels that have a high correlation with nociceptive symptoms. In this review, we explored the current evidence in support of the involvement of sympathetic overactivity in CBP. As bladder inflammation often occurs among subgroups of CBP patients, we discuss the possible role of sympathetic nervous system in mastocytosis as well examples examples of animal models that further support the involvement of sympathetic dysfunction in CBP. As there is substantive evidence for cross-organ sensitization in the pelvis can lead to co-morbidity of genitourinary and gastrointestinal dysfunctions, we also include how sympathetic dysfunction may play a role in a number of co-morbid chronic pain syndromes.
Translational andrology and urology. 2015 Oct [Epub]
Ana Charrua, Rui Pinto, Lori Ann Birder, Francisco Cruz
1 I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal ; 2 IBMC-Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal ; 3 Department of Renal, Urologic and Infectious diseases, Faculty of Medicine of University of Porto, Porto, Portugal ; 4 Department of Urology, Hospital S. João, Porto, Portugal ; 5 Departments of Medicine and Pharmacology-Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. , 1 I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal ; 2 IBMC-Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal ; 3 Department of Renal, Urologic and Infectious diseases, Faculty of Medicine of University of Porto, Porto, Portugal ; 4 Department of Urology, Hospital S. João, Porto, Portugal ; 5 Departments of Medicine and Pharmacology-Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. , 1 I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal ; 2 IBMC-Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal ; 3 Department of Renal, Urologic and Infectious diseases, Faculty of Medicine of University of Porto, Porto, Portugal ; 4 Department of Urology, Hospital S. João, Porto, Portugal ; 5 Departments of Medicine and Pharmacology-Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. , 1 I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal ; 2 IBMC-Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal ; 3 Department of Renal, Urologic and Infectious diseases, Faculty of Medicine of University of Porto, Porto, Portugal ; 4 Department of Urology, Hospital S. João, Porto, Portugal ; 5 Departments of Medicine and Pharmacology-Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.