Post-Infectious Bladder Hypersensitivity in the Development of Interstitial Cystitis/ Bladder Pain Syndrome (IC/BPS)

The bladder is innervated by a complex network of afferent nerves that project into the spinal cord, providing sensory input to the central nervous system to regulate normal bladder function. Patients with interstitial cystitis/bladder pain syndrome (IC/BPS) experience painful bladder sensations during normal bladder filling, which leads to the development of chronic pelvic pain and bladder dysfunction. Increased urothelial permeability and inflammation are key contributing factors in the sensitisation of bladder-innervating afferents and development of chronic pelvic pain in IC/BPS patients. However, the mechanisms that underlie the pathogenesis of IC/BPS have yet to be determined. Urinary tract infections (UTIs) are by far the most common pathological insult that occurs in the bladder, and accumulating clinical and pre-clinical studies support a role for UTI in the etiopathogenesis of IC/BPS. This mini-review summarises the epidemiological studies identifying UTI as a significant risk factor for the development of IC/BPS and discusses the complex interactions underlying UTI-induced urothelial permeability, inflammation, and neuroplasticity that may contribute to the development of post-infectious bladder hypersensitivity and IC/BPS.