Urothelial and Afferent Mechanisms Inducing Bladder Pain in Interstitial Cystitis

Abstract

Although the symptoms of interstitial cystitis (IC)–a debilitating, chronic disease characterized by urinary urgency and frequency, and bladder and pelvic pain on bladder filling–are easily confused with those of urinary tract infections, there is an absence of an underlying infection, and antibiotic therapy is of no therapeutic benefit. Severe cases of this disorder, which affects primarily women, can have considerable impact on the quality of life of patients due to extreme pain and urinary frequency, which are often difficult to treat. Although the etiology of IC is still not known, several potential pathogeneses including epithelial dysfunction, increased urothelial-afferent interaction, neurogenic inflammation and hyperexcitability of bladder afferent pathways have been proposed. As knowledge of the pathogenesis of IC increases through intensified research, the ability to provide effective treatments to patients with this disease will improve.