2013
DOI: 10.1016/j.juro.2012.11.019
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Evidence for Overlap Between Urological and Nonurological Unexplained Clinical Conditions

Abstract: The overlap between urological and selected nonurological unexplained clinical conditions is substantial. Future research should focus on using standardized definitions, and rigorously designed, well controlled studies to further assess comorbidity, clarify the magnitude of the association and examine common pathophysiological mechanisms.

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Cited by 101 publications
(68 citation statements)
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“…Second, the behavioral and molecular changes resulting from NMS are largely due to dysregulation of the HPA axis [15][16][17][18] , suggesting that the effect is centrally-mediated and could have comorbid results, including changes in anxiety-and/or depression-like behaviors and increased sensitivity in other pelvic organs or more distant locations. This comorbid phenotype is indicative of what is commonly seen clinically and may be more representative of CP/CPPS patients as a whole 5,[28][29][30][31]42 . Third, based on these changes occurring as a result of HPA axis dysregulation, the impact of stress should be of utmost concern during both the NMS procedure and later behavioral testing and in vitro analysis.…”
Section: Discussionmentioning
confidence: 91%
See 1 more Smart Citation
“…Second, the behavioral and molecular changes resulting from NMS are largely due to dysregulation of the HPA axis [15][16][17][18] , suggesting that the effect is centrally-mediated and could have comorbid results, including changes in anxiety-and/or depression-like behaviors and increased sensitivity in other pelvic organs or more distant locations. This comorbid phenotype is indicative of what is commonly seen clinically and may be more representative of CP/CPPS patients as a whole 5,[28][29][30][31]42 . Third, based on these changes occurring as a result of HPA axis dysregulation, the impact of stress should be of utmost concern during both the NMS procedure and later behavioral testing and in vitro analysis.…”
Section: Discussionmentioning
confidence: 91%
“…Patients with CP/CPPS report pain in the perineum, rectum, prostate, penis, testicles, and/or abdomen 28 , experience a higher degree of psychological stress than control patients 29 , and commonly present with symptoms of or are diagnosed with comorbid chronic pelvic pain or mood disorders 5,[29][30][31] . Recurrent infection, leaky epithelium, neurogenic inflammation, and autoimmunity have all been surmised as potential underlying causes of CP/CPPS 2,32,33 , as well as mast cell activation and degranulation 34 .…”
Section: Introductionmentioning
confidence: 99%
“…Patients with CP/CPPS and “central pain” syndromes, such as fibromyalgia or chronic fatigue syndrome, often present with similar or overlapping symptoms. Therefore, it has been suggested to view and treat CP/CPPS as another “central pain” syndrome instead of a prostatic disease (3, 31). Interestingly, data from intervention trials and meta-analyses suggest that exercise may reduce severity of symptoms associated with several “central pain” related syndromes and exercise is often included in the management of fibromyalgia or chronic fatigue syndrome (4, 14, 36, 38).…”
Section: Discussionmentioning
confidence: 99%
“…Indeed, the overlap observed between OAB and IBS might reflect the existence of a common pathophysiology 83,94 , although the nature of the underlying mechanisms has not been examined. Various reports in the literature suggest the existence of overlap between OAB and some of the more commonly recognized central sensitization syndromes 36,41 , including IBS 77,92,94,120,121 , fibromyalgia 122–126 , and idiopathic back pain 127 . According to population data, over one-third of Japanese women with OAB have concomitant IBS, as defined by Rome criteria 128 , whereas American women are more likely to report a diagnosis of IBS if they have more severe storage-type lower urinary tract symptoms 120 .…”
Section: Current Evidencementioning
confidence: 99%