{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T07:03:30Z","timestamp":1779779010943,"version":"3.53.1"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":144,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Urology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:label\/>\n                    <jats:p>Persistent genital arousal disorder\/genito\u2010pelvic dysesthesia (PGAD\/GPD) is a rare and distressing condition characterized by unwanted genital arousal without associated sexual desire. While cases of PGAD\/GPD in association with interstitial cystitis, urethritis, urinary tract infection, and urethral diverticulum have been described, bladder cancer has not yet been reported. To our knowledge, the present report describes the first known case of PGAD\/GPD as the initial presentation of low\u2010grade papillary urothelial carcinoma of the bladder in a young female.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 26 year\u2010old healthy female presented with a 3\u2010month history of constant, distressing clitoral engorgement, throbbing, and pain in her vulvar vestibule that began during masturbation. She also noted dysuria, urinary frequency, urgency, intermittent hematuria, and nocturia two to three times per night, pelvic floor hypertonicity, and restless legs. She denied any smoking history but did report a history of occasional resin exposure while making jewelry as a hobby. She underwent a bladder ultrasound that revealed a 7 \u00d7 5 \u00d7 6\u2010mm nonmobile lesion in the left posterior bladder wall, lateral to the ureteral orifice. Cystoscopy and pathology revealed low\u2010grade papillary (Ta) urothelial carcinoma of the bladder, and transurethral resection of bladder tumor was performed. Symptoms had completely resolved 3 months after the procedure, with continued use of topical lidocaine gel applied to the clitoris and pelvic floor physical therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our postulate to account for the constellation of symptoms tumor\u2010induced chronic irritation of the pelvic nerve resulting in reflexive bladder hypermotility, clitoral engorgement, and bowel dysfunction. In addition, central cross\u2010sensitization at the level of the sacral spinal cord could activate the postsynaptic neurons that normally respond to pudendal nerve afferent activity, resulting in clitoral and vestibular dysesthesia, reflexive pelvic floor hypertonicity via postsynaptic pudendal nerve efferents, and reflexive restless legs via postsynaptic sciatic nerve efferents. Further investigation is warranted to better understand the relationship between bladder tumors, PGAD\/GPD, and related viscero\u2010visceral and viscero\u2010somatic reflex activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/criu\/3816720","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T06:25:59Z","timestamp":1779776759000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low\u2010Grade Papillary Urothelial Carcinoma of the Bladder Presenting as Persistent Genital Arousal Disorder\/Genito\u2010Pelvic Dysesthesia: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4205-9733","authenticated-orcid":false,"given":"Sarah","family":"Ponce","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7572-9475","authenticated-orcid":false,"given":"Eliza","family":"Burr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Davide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2306-7198","authenticated-orcid":false,"given":"\u00c9v\u00e9line","family":"Poirier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0286-5249","authenticated-orcid":false,"given":"Marta","family":"Kolbuszewska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shari","family":"McKinny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel S.","family":"Rubin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3164-9174","authenticated-orcid":false,"given":"Barry R.","family":"Komisaruk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irwin","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2021.01.172"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jsxmed\/qdac017"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jsxmed\/qdaf124"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.12.011"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21820"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-020-03376-9"},{"key":"e_1_2_12_7_2","first-page":"10454","article-title":"Young Population Bladder Neoplasms","volume":"27","author":"\u00c7etin K. \u00c7.","year":"2023","journal-title":"European Review for Medical & Pharmacological Sciences"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16234100"},{"key":"e_1_2_12_9_2","volume-title":"Diagnosis, Evaluation and Follow-Up of Asymptomatic Microhematuria (AMH) in Adults: AUA Guideline","author":"Lin D. W.","year":"2020"},{"key":"e_1_2_12_10_2","volume-title":"NCCN Clinical Practice Guidelines in Oncology: Bladder Cancer and Upper Tract Urothelial Carcinoma","author":"National Comprehensive Cancer Network","year":"2026"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.09.030"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2016.95"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002130"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2009.06.012"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2007.07.053"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/jsxmed\/qdag063.070"},{"key":"e_1_2_12_17_2","volume-title":"BMJ Case Reports: Patient Consent Form","author":"BMJ Publishing Group","year":"2026"},{"key":"e_1_2_12_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sxmr.2016.06.003"},{"key":"e_1_2_12_19_2","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.7.4.524"},{"key":"e_1_2_12_20_2","volume-title":"Manual for the Beck Depression Inventory-II","author":"Beck A. T.","year":"1996"},{"key":"e_1_2_12_21_2","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.56.6.893"}],"container-title":["Case Reports in Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/criu\/3816720","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/criu\/3816720","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/criu\/3816720","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T06:26:04Z","timestamp":1779776764000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/criu\/3816720"}},"subtitle":[],"editor":[{"given":"Selcuk","family":"Yucel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/criu\/3816720"],"URL":"https:\/\/doi.org\/10.1155\/criu\/3816720","archive":["Portico"],"relation":{},"ISSN":["2090-696X","2090-6978"],"issn-type":[{"value":"2090-696X","type":"print"},{"value":"2090-6978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-09-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"3816720"}}