Skip to main content

Advertisement

SpringerLink
Log in

Chronic urologic pain syndromes

  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Chronic pains typically evaluated by a urologist are discussed from the perspective of a non-urologist pain clinician. The pathophysiology of some pains is understood and so we believe the patient’s symptoms: examples are cancer-related pain and recurrent urolithiasis. We treat these pains with traditional analgesics. Other pains, such as those of interstitial cystitis, chronic prostatodynia, and chronic orchialgia are less understood and so are treated in a more conservative and often empiric fashion. Proposed therapies for these disorders are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Ness TJ: Chronic abdominal, groin and perineal pain of visceral origin. In Textbook of Clinical Pain Management—Volume 3—Chronic Pain. Edited by Wilson PR et al. lLondon: Arnold; 2000, in press.

  2. Gray CL, Kane CJ: Drug seeking behavior in urolithiasis in the noncontrast computed tomography era: 2 cases. Urology 1999, 54:744.

    Article  PubMed  CAS  Google Scholar 

  3. Niall O, Russell J, MacGregor R, et al.: A comparison of noncontrast computerized tomography with excretory urography in the assessment of acute flank pain. J Urol 1999, 161:534–537.

    Article  PubMed  CAS  Google Scholar 

  4. Wein AJ, Hanno PM, Gillenwater JY: Interstitial cystitis: an introduction to the problem. In Interstitial Cystitis. Hanno PM et al. New York: Springer-Verlag; 1990:3–16.

    Google Scholar 

  5. Hanno PM, Landis JR, Matthews-Cook Y, et al.: The diagnosis of interstitial cystitis revisited: lesson learned form the National Institutes of Health Interstitial Cystitis Database study. J Urol 1999, 161:553–557.

    Article  PubMed  CAS  Google Scholar 

  6. Waxman JA, Sulak PJ, Kuehl TJ: Cystoscopic findings consistent with interstitial cystitis in normal women undergoing tubal ligation. J Urol 1998, 160:1663–1667. This paper suggests that bladder mucosal lesions following hydrodistension (glomerulations) may be common in asymptomatic women. This brings into question the use of this finding as part of the diagnostic criteria for IC.

    Article  PubMed  CAS  Google Scholar 

  7. Keay S, Warren JW: A hypothesis for the etiology of interstitial cystitis based upon inhibition of bladder epithelial repair. Med Hypotheses 1998, 51:79–83.

    Article  PubMed  CAS  Google Scholar 

  8. Alagiri M, Chottiner S, Ratner V, et al.: Interstitial cystitis: unexplained associations with other chronic disease and pain syndromes. Urology 1997, 49(suppl 5A):52–57.

    Article  PubMed  CAS  Google Scholar 

  9. Erickson DR, Sheykhnazari M, Ordille S, Bhavanandan VP: Increased hyaluronic acid and interstitial cystitis. J Urol 1998, 160:1282–1284.

    Article  PubMed  CAS  Google Scholar 

  10. Okragly AJ, Niles AL, Saban R, et al.: Elevated tryptase, nerve growth factor, neurotrophin-3 and glial cell line-derived neurotrophic factor levels in the urine of interstitial cystitis and bladder cancer patients. J Urol 1999, 161:438–441.

    Article  PubMed  CAS  Google Scholar 

  11. Stein PC, Torri A, Parsons CL: Elevated urinary norepinephrine in interstitial cystitis. Urology 1999, 53:1140–1143.

    Article  PubMed  CAS  Google Scholar 

  12. Byrne DS, Sedor JF, Estojak J, et al.: The urinary glycoprotein GP51 as a clinical marker for interstitial cystitis. J Urol 1999, 161:1786–1790.

    Article  PubMed  CAS  Google Scholar 

  13. Peeker R, Aldenborg F, Haglid K, et al.: Decreased levels of S-100 protein in non-ulcer interstitial cystitis. Scand J Urol Nephrol 1998, 32:395–398.

    Article  PubMed  CAS  Google Scholar 

  14. Keay S, Zhang CO, Kagen DI, et al.: Concentration of specific epithelial growth factors in the urine of interstitial cystitis patients and controls. J Urol 1997, 158:1983–1988.

    Article  PubMed  CAS  Google Scholar 

  15. Keay S, Zhang CO, Hise MK, et al.: A diagnostic in vitro urine assay for interstitial cystitis. Urology 1998, 52:974–978. This paper suggests that the measurement of a urine factor responsible for epithelial antiproliferative activity may be a useful noninvasive means for diagnosing IC. Subsequent papers have provided further support for this assertion.

    Article  PubMed  CAS  Google Scholar 

  16. Keay S, Warren JW, Zhang CO, et al.: Antiproliferative activity is present in bladder but not renal pelvic urine from interstitial cystitis patients. J Urol 1999, 162:1487–1489.

    Article  PubMed  CAS  Google Scholar 

  17. Chai TC, Shang CO, Shoenfelt JL, et al.: Bladder stretch alters urinary heparin-binding epidermal growth factor and antiproliferative factor in patients with interstitial cystitis. J Urol 2000, 163:1440–1444.

    Article  PubMed  CAS  Google Scholar 

  18. Curhan GC, Speizer FE, Hunter DJ, et al.: Epidemiology of interstitial cystitis: a population based study. J Urol 1999, 161:549–552. This survey study of female participants in the Nurses’ Health Study I and II suggest that the prevalence of IC in females in the United States is 50% to 150% greater than previously reported.

    Article  PubMed  CAS  Google Scholar 

  19. Pontari MA, Hanno PM, Wein AJ: Logical and systematic approach to the evaluation and management of patients suspected of having interstitial cystitis. Urology 1997, 49:(suppl 5A):114–120.

    Article  Google Scholar 

  20. Held PJ, Hanno PM, Wein AJ: Epidemiology of interstitial cystitis. In Interstitial Cystitis. Edited by Hanno PM. London: Springer-Verlag; 1990:29–48.

    Google Scholar 

  21. Jepsen JV, Sall M, Rhodes PR, et al.: Long-term experience with pentosanpolysulfate in interstitial cystitis. Urology 1998, 51:381–387.

    Article  PubMed  CAS  Google Scholar 

  22. Teichman JM, Nielsen-Omeis BJ: Potassium leak test predicts outcome in interstitial cystitis. J Urol 1999, 161:1791–1794.

    Article  PubMed  CAS  Google Scholar 

  23. Forsell T, Ruutu M, Isoniemi H, et al.: Cyclosporine in severe interstitial cystitis. J Urol 1996, 155:1591–1593.

    Article  PubMed  CAS  Google Scholar 

  24. Moran PA, Dwyer PL, Carey MP, et al.: Oral methotrexate in the management of refractory interstitial cystitis. Aust N Z J Obstet Gynaecol 1999, 39:468–471.

    PubMed  CAS  Google Scholar 

  25. Peters KM, Diokno AC, Steinert BW, Gozales JA: The efficacy of intravesical bacillus Calmette-Guerin in the treatment of interstitial cystitis: long-term follow up. J Urol 1998, 159:1483–1486.

    Article  PubMed  CAS  Google Scholar 

  26. Irwin PP, Hammonds WD, Galloway NTM: Lumbar epidural blockade for management of pain in interstitial cystitis. Br J Urol 1993, 71:413–416.

    Article  PubMed  CAS  Google Scholar 

  27. Cadeddu JA, Bishoff JT, Chan DY, et al.: Laparoscopic testicular denervation for chronic orchalgia. J Urol 1999, 162:733–735.

    Article  PubMed  CAS  Google Scholar 

  28. Wesselmann U, Burnett AL, Heinberg LJ: The urogenital and rectal pain syndromes. Pain 1997, 73:269–294.

    Article  PubMed  CAS  Google Scholar 

  29. Miller JL, Rothman I, Bavendam TG, Berger RE: Prostatodynia and interstitial cystitis: one and the same? Urology 1995, 45:587–590.

    Article  PubMed  CAS  Google Scholar 

  30. Shoskes DA, Zeitlan SI, Shahed A, Rajfer J: Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology 1999, 54:960–963. This controlled study suggests that a bioflavonoid found in red wine may produce significant symptomatic improvement in males with prostatodynia. Few studies to date have demonstrated clear benefit in this population.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Alabama at Birmingham, 937 Zeigler Research Building, 619 19th Street South, 35233, Birmingham, AL, USA

    Timothy J. Ness MD, PhD

Authors
  1. Timothy J. Ness MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ness, T.J. Chronic urologic pain syndromes. Current Science Inc 5, 27–34 (2001). https://doi.org/10.1007/s11916-001-0007-0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-001-0007-0

Keywords

Search

Navigation