Syndromes Associated with Bladder Pain Syndrome as Clues to its Pathogenesis

  • John W. Warren
  • Joop P. van de Merwe
  • J. Curtis Nickel


Over the last decade, what were once distinct pathways to understanding the pathogenesis of bladder pain syndrome (BPS) have become fainter. Fortunately, during this time several investigative groups intensively have been examining the association with BPS of several syndromes with symptoms outside the bladder (non-bladder syndromes, NBSs) and in so doing opened a new exploratory path.

The NBSs are fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, sicca syndrome, chronic pelvic pain, migraine, allergies, asthma, depression, anxiety, temporomandibular disorder, low back pain, and vulvodynia. Three findings about these NBSs are pertinent to BPS pathogenesis: (1) many NBSs are associated with BPS; (2) many NBSs are associated with each other; and (3) many NBSs precede the onset of BPS.

These findings have generated three hypotheses: (a) that BPS initiates a pathophysiology that results in NBSs, (b) that NBSs initiate a pathophysiology that results in BPS, and (c) that a preceding pathophysiology results in the NBSs and BPS. A well-designed longitudinal study likely will be necessary to distinguish among these three hypotheses.


Systemic Lupus Erythematosus Irritable Bowel Syndrome Chronic Fatigue Syndrome Interstitial Cystitis Irritable Bowel Syndrome Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • John W. Warren
    • 1
  • Joop P. van de Merwe
    • 2
  • J. Curtis Nickel
    • 3
  1. 1.Medicine and Epidemiology and Public HealthUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Departments of Immunology and Internal Medicine, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
  3. 3.Urology Department, Kingston General HospitalQueen’s UniversityKingstonCanada

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