{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:01:29Z","timestamp":1780333289445,"version":"3.54.1"},"reference-count":23,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Urol Int"],"abstract":"<jats:p>Background: The catalyst for this analysis was a statement by Dr. Magnus Fall at a meeting of invited experts in 2020 of IC\/BPS (interstitial cystitis\/bladder pain syndrome): \u201cA paradigm shift in the understanding of IC\/BPS is urgent.\u201d This review analyses such a paradigm shift. Summary: The paradigm shift began with the serendipitous cure of Hunner\u2019s lesion in a woman with a diagnosis of posterior fornix syndrome (PFS) and uterine prolapse. Retrospective analysis of surgical data from eight PFS studies reporting pain and urge cure found PFS was consistent with IC\/BPS definitions. No Hunner\u2019s lesions\/ulcers were reported in the eight studies. Anatomical pathways for urge\/frequency were consistent with Tanagho\u2019s descriptions of normal micturition (albeit prematurely activated); pathways for abnormal emptying\/retention were consistent with inability of pelvic muscles to open the posterior urethral wall prior to micturition; pathways for pelvic pain were consistent with de novo impulses from pelvic visceral plexuses caused by unsupported USLs (uterosacral ligaments). Key Messages: As PFS and IC\/BPS have similar symptoms, USL repair of prolapse can potentially deliver improvement\/cure for urge and pain symptoms, provided diagnostic PFS criteria (e.g., speculum test) for PFS are met. Two hypotheses explain inflammatory end-organ responses observed in Hunner\u2019s IC\/BPS and offer new research directions.<\/jats:p>","DOI":"10.1159\/000547785","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T16:07:32Z","timestamp":1754410052000},"page":"306-316","source":"Crossref","is-referenced-by-count":0,"title":["The Posterior Fornix Syndrome Is an Important Differential Diagnosis for Interstitial Cystitis\/Bladder Pain Syndrome"],"prefix":"10.1159","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9611-3258","authenticated-orcid":false,"given":"Peter Emanuel","family":"Petros","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8816-0786","authenticated-orcid":false,"given":"Maren Juliane","family":"Wenk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2646-823X","authenticated-orcid":false,"given":"Bernhard","family":"Liedl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1861-1630","authenticated-orcid":false,"given":"Klaus","family":"Goeschen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1932-5270","authenticated-orcid":false,"given":"Jacob","family":"Bornstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1159\/000515647"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/nau.1930120305"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.5173\/ceju.2017.938"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.14740\/jcgo696"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.5173\/ceju.2021.0208"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24990"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13413"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/s0306-3356(21)00669-5"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1159\/000539647"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.cont.2023.101057"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.cont.2023.101056"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.21037\/atm-23-1815"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1159\/000524321"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-022-05151-3"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828x.1996.tb02727.x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04440-z"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.34057\/PPj.2021.40.04.2021-7-7"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.21037\/atm-23-1774"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1080\/21681805.2020.1744714"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1520-6777(1999)18:23.0.co;2-z"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2004.00297.x"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04649-y"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-013-1150-z"}],"container-title":["Urologia Internationalis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000547785","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:05:01Z","timestamp":1780329901000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000547785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6,1]]},"published-print":{"date-parts":[[2026,6,3]]}},"URL":"https:\/\/doi.org\/10.1159\/000547785","archive":["Portico"],"relation":{},"ISSN":["0042-1138","1423-0399"],"issn-type":[{"value":"0042-1138","type":"print"},{"value":"1423-0399","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,4]]}}}