Hypersensory Bladder Disease: Concept and Pathogenetic Basis

This review article is devoted to current concepts of hypersensory bladder. It provides a detailed description of the epidemiological, clinical, and pathophysiological features of overactive bladder and bladder pain syndrome / interstitial cystitis, emphasizing the similarity of their clinical manifestations. The molecular mechanisms of the mechanosensory function of the urothelium under normal conditions and in the presence of hypersensory disorders are thoroughly described. The data presented allow these conditions to be regarded as manifestations of a common pathological process based on increased bladder sensitivity. It is noted that the mechanism of hypersensitivity in overactive bladder and bladder pain syndrome / interstitial cystitis is similar and involves the pathological amplification of afferent signal transmission from the bladder to the central nervous system. This process may be associated with multiple factors, but inflammation is regarded as the main cause of increased afferent activity in the bladder. The role of central sensitization in the development of hypersensory bladder disorders is also highlighted. Given the commonality in symptoms, clinical course, and pathogenesis, the concept of “hypersensory bladder disease” is proposed, uniting the hypersensory phenotypes of overactive bladder and bladder pain syndrome / interstitial cystitis. It is stated that this concept is justified from a pathogenetic standpoint, although many aspects require further investigation and discussion.