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Mechanisms Underlying Overactive Bladder and Interstitial Cystitis/Painful Bladder Syndrome
Luke Grundy1,2, Ashlee Caldwell1,2, Stuart M Brierley1,2
1Visceral Pain Research Group, Centre for Neuroscience, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Frontiers in Neuroscience
|January 9, 2019
Summary
Overactive bladder syndrome (OAB) and painful bladder syndrome (IC/PBS) involve complex sensory pathway changes. Understanding these mechanisms from bladder to brain is crucial for developing effective treatments for urological disorders.
Area of Science:
- Neuroscience
- Urology
- Pain Research
Background:
- Bladder sensory input travels to the spinal cord's dorsal horn, influencing micturition centers.
- Normally unnoticed bladder distension becomes exaggerated in conditions like OAB and IC/PBS.
- OAB and IC/PBS, once seen as distinct, share underlying neuroplastic changes in bladder sensation pathways.
Purpose of the Study:
- To review the interconnected mechanisms underlying chronic urological disorders.
- To explore how urothelial dysfunction, inflammation, and cross-organ sensitization contribute to bladder sensory alterations.
- To examine the role of emotional processing and stress in exacerbating bladder dysfunction.
Main Methods:
- Literature review of clinical and pre-clinical evidence.
- Discussion of neuroplasticity in the sensory pathways mediating bladder sensation.
- Analysis of factors including urothelial function, inflammation, and central pain processing.
Main Results:
- Evidence suggests OAB and IC/PBS stem from structural or synaptic changes in bladder sensory pathways.
- Urothelial dysfunction, increased permeability, and inflammation can drive neuroplasticity.
- Psychological factors like stress, anxiety, and depression significantly worsen bladder sensation and function.
Conclusions:
- Chronic urological disorders involve complex, interconnected mechanisms from the bladder to the brain.
- Aberrant bladder sensation and dysfunction are linked to urothelial changes, inflammation, and central pain processing.
- A comprehensive understanding of the entire sensory pathway is essential for targeted therapeutic development.
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