Afferent Neurourology: An Epidemiological Perspective

Purpose

Multiple urological conditions are characterized by bothersome sensations such as pain or urinary urgency. There is significant confusion about the etiology and pattern of these symptoms.

Materials and Methods

The term afferent neurourology is introduced to describe the study of sensory processing related to the genitourinary tract. Epidemiological studies related to afferent neurourology are reviewed and unique challenges to our understanding of these disorders are described.

Results

Afferent urological disorders are characterized by urological pain or urinary urgency. Conceptually these afferent disorders can be differentiated from efferent urological disorders and structural urological abnormalities. Afferent urological disorders are common in men and women, although symptom severity is variable. Study of the entire disease spectrum may provide insight into pathogenesis and prevention. The natural history of these symptoms is poorly understood. Afferent urological disorders commonly co-occur with other poorly understood somatic symptoms, suggesting that symptoms may be due to a systemic disorder in certain individuals. Mechanisms responsible for these sensory abnormalities are poorly understood and may arise from central and peripheral abnormalities.

Conclusions

Urinary pain and urgency are common, bothersome symptoms that are currently understood poorly and managed ineffectively. Intentional recognition of sensory urological abnormalities as a separate field of study may enhance research efforts into these conditions and improve treatment outcomes.

Key Words: urinary bladder, cystitis, interstitial, pain, prostatitis, epidemiology

Abbreviations and Acronyms: CP, chronic prostatitis, CPPS, chronic pelvic pain syndrome, GU, genitourinary, IC, interstitial cystitis, LUTS, lower urinary tract symptoms, NHS, Nurses' Health Study, NIH, National Institutes of Health, OAB, overactive bladder, PBS, painful bladder syndrome