{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T13:59:58Z","timestamp":1781704798722,"version":"3.54.5"},"reference-count":60,"publisher":"Korean Continence Society","issue":"2","license":[{"start":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T00:00:00Z","timestamp":1719705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["einj.org"],"crossmark-restriction":true},"short-container-title":["Int Neurourol J"],"published-print":{"date-parts":[[2024,6,30]]},"abstract":"<jats:p>To critically analyse the relationship of bladder pain syndrome (BPS\/IC), as defined, to the posterior fornix syndrome, \u201cPFS\u201d predictably co-occurring bladder urgency, frequency, nocturia, chronic pelvic pain, emptying symptoms\/retention, caused by uterosacral ligament (USL) laxity and cured by USL repair. The starting and end points of this paper are the questions, \u201cAre there arguments that BPS\/IC can, in some cases, be linked to PFS?\u201d And if so, \u201cTo what extent?\u201d We used the criteria required by Ueda for proper diagnosis: \u201cunderstanding symptoms, detecting abnormal findings and verifying them as a cause of the symptoms.\u201d Literature, diagnostic and surgical, indicate that chronic pelvic pain \u201cof unknown origin\u201d can be caused by unsupported visceral pelvic plexuses because of weak USLs; these cause fire of afferent impulses, which the brain mistakenly interprets as coming from the end-organ itself (i.e., genitourinary pain, lower urinary tract symptoms). The same lax USLs can also weaken the pelvic muscles which contract to stretch the vagina to support the urothelial stretch receptors from below: these may prematurely fire off afferent impulses to activate micturition at lower bladder volumes, interpreted as urgency. A speculum placed in the vagina can relieve pain and urgency by mechanically supporting the vaginal wall and USLs, thus predicting an eventual cure by USL repair. There is need to evaluate what percentage of women with known BPS\/IC also pass the criteria for PFS. Identifying a significant percentage of BPS\/IC women with the causative relation between PFS pathogenesis and BPS\/ IC may open a new way of diagnosing and treating BPS\/IC in some women.<\/jats:p>","DOI":"10.5213\/inj.2346344.172","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T01:13:40Z","timestamp":1719450820000},"page":"96-105","update-policy":"https:\/\/doi.org\/10.5213\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Critical Examination of Ligamentous Pathogenesis of Bladder Pain\/Lower Urinary Tract Symptoms Using the UEDA Criteria"],"prefix":"10.5213","volume":"28","author":[{"given":"J\u00f6rgen","family":"Quaghebeur","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0879-6854","authenticated-orcid":true,"given":"Jean-Jacques","family":"Wyndaele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9611-3258","authenticated-orcid":true,"given":"Peter","family":"Petros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3166","reference":[{"key":"ref1","volume-title":"","author":"Engeler","year":"2023"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001390"},{"key":"ref3","first-page":"e106","volume-title":"PD08-04 Cystoscopic detection of Hunner lesions assisted with machine learningbased algotrihm in interstitial cystitis\/bladder pain syndrome (IC\/ BPS) patients","author":"Ueda","year":"2022"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1080\/21681805.2020.1730948"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.09.019"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.06.112"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(78)90286-8"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.5213\/inj.2142084.042"},{"key":"ref9","first-page":"55","volume-title":"Mechanical support of the posterior fornix relieved urgency and suburethral tenderness","author":"Wu","year":"2013"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.2147\/jpr.s296613"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1520-6777(1999)18:2<81::aid-nau3>3.3.co;2-q"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/s0021-9290(97)00050-x"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1159\/000524321"},{"key":"ref14","first-page":"436","volume-title":"Retention of urine in women is alleviated by uterosacral ligament repair: implications for Fowler\u2019s syndrome","author":"Petros","year":"2018"},{"key":"ref15","first-page":"53","volume-title":"Is overactive bladder in the female surgically curable by ligament repair?","author":"Liedl","year":"2017"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-013-1150-z"},{"key":"ref17","first-page":"372","volume-title":"Native tissue repair of cardinal\/uterosacral ligaments cures overactive bladder and prolapse, but only in pre- menopausal women","author":"Shkarupa","year":"2021"},{"key":"ref18","first-page":"89","volume-title":"The Bornstein Test- a local anaesthetic technique for testing uterosacral nerve plexus origins of chronic pelvic pain","author":"Zarfati","year":"2017"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/bf02765483"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13413"},{"key":"ref21","first-page":"490","volume-title":"A low cost artisan tension-free tape technique cures pelvic organ prolapse and stress urinary incontinence - proof of concept","author":"Pi\u00f1ango-Luna","year":"2020"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14453"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.14740\/jcgo696"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04440-z"},{"key":"ref25","first-page":"52","volume-title":"TFS posterior sling improves overactive bladder, pelvic pain and abnormal emptying, even with minor prolapse. 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