Is Urethral Pain Syndrome Really Part of Bladder Pain Syndrome?

Abstract

Urethral pain syndrome is a symptom complex that includes dysuria, urinary urgency, frequency, nocturia, and persistent or intermittent urethral and/or pelvic pain in the absence of proven infection. Bladder pain syndrome is a clinical diagnosis, based primarily on chronic symptoms of pain from the bladder and/or pelvis associated with urinary urgency or frequency in the absence of identified cause for the symptoms. To date, the term, urethral pain syndrome, remains to be unclear in referring to a distinct subgroup of bladder pain syndrome. However, these two syndromes share many similarities, except the organ of pain. This review is intended to summarize the current state of literature with regard to similar pathophysiology and possible interrelations between urethral pain syndrome and bladder pain syndrome.

In vivo assessment of structural changes of the urethra in lower urinary tract disease using cross-polarization optical coherence tomography

“…It is this group of diseases that includes a pathological conditionurethral pain syndrome (UPS) that is considered as part of a complex of chronic pelvic pain pathologies. 1,2 According to Ref. 1, every 3-4 women periodically complain of pain in the urethra, or pelvis, or of discomfort during urination, or sexual activity.…”

“…Often, long-lasting complaints lead to restrictions on professional activities, problems in family relationships (including sexual), temporary or permanent disability. 1 UPS is characterized by persistent or recurrent pain in the urethra in the absence of con¯rmed infection or other obvious local pathological changes. Clinical guidelines for chronic pelvic pain developed by experts at the European Association of Urology (EAU) state that UPS is a polyetiological disease that requires a multimodal approach to the diagnosis and management of treatment.…”

“…The mechanisms underlying bladder pain syndrome and chronic pelvic pain in general are currently being discussed. 1,[3][4][5] The cause of pain in UPS can be a violation of innervation processes, changes in the work of nerve synapses, tissue ischemia in the pelvis, etc. It is believed that the main type of pain in chronic pain syndrome (in our case, in UPS) is dysfunctional pain arising in the absence of activation of nociceptors (\pain receptors") and visible organic damage, including lesions of the nervous system.…”

“…It is believed that the main type of pain in chronic pain syndrome (in our case, in UPS) is dysfunctional pain arising in the absence of activation of nociceptors (\pain receptors") and visible organic damage, including lesions of the nervous system. 1 At present, it has been proven that one of the leading causes of any in°ammatory diseases of the bladder is the dysfunction of its protective barrierepithelium. 6,7 A close relationship between embryonic development and neighboring topological location of the urethra and urinary bladder, covered with urothelium, makes the presence of the same reasons in origin and progression of UPS as in the interstitial cystitis possible.…”

New Findings in the Study of the Pathogenesis of Urethral Pain Syndrome

“…The most common reason for women to seek medical attention is dysuria, and it is believed that in 40% of cases urethritis and / or urethral syndrome are involved [1]. According to the US National Institutes of Health, one third of women with chronic pelvic pain (CPP) have urethral pain syndrome (UPS) [2,3]. The European Association of Urology defines UPS as the occurrence of chronic or recurrent episodic pain lasting for more than 6 months, and felt in the urethra, in the absence of proven infection or other obvious local pathology.…”