Table 1.
Symptom | Putative neural mechanisms(s) | Neuraxis level |
---|---|---|
Pain associated with bladder filling and relieved with bladder emptying | Afferent sensitization to mechanoreceptors | Peripheral nerve |
Sensory modality shift from mechanical to nociceptive | Spinal cord | |
Central sensitization to bladder filling | Brainstem or thalamus | |
Urgency due to pain; Urination >10 times per day and >2 times per night | Sensory axon reflex impacting detrusor sensitivity to parasympathetic efferents | Peripheral nerve |
Detrusor hyperreflexia | Spinal cord | |
Inadequate detrusor inhibition from pontine centers due to pain sensitization | Brainstem |