title: Urgency and pain in patients with overactive bladder and bladder pain syndrome. What are the differences?
abstract: BACKGROUND
  The Overactive Bladder Syndrome (OAB) and the Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) are different urological conditions sharing 'urgency' as a common symptom. The aim of this review is to address our existing knowledge and establish how these symptoms are interrelated and to determine whether or not there is a common link between both symptoms complexes that help to distinguish one from the other.
  
  
  METHODS
  Pubmed was used to obtain references for this non-systematic review aiming to discuss differences between OAB and BPS/IC. Guidelines of several professional associations and discussions based on expert opinion from the authors were implemented.
  
  
  RESULTS
  Whilst in BPS the hallmark symptom is pain on bladder filling, urgency is the defining symptom of OAB. Whilst it is likely that the pain in BPS/IC arises from local inflammation in the bladder wall, the nature of urgency as a symptom, its origin, and the relationship between urgency and pain, as well as the different afferent mechanisms associated with the genesis of these sensory symptoms, remains unknown. Although the aetiology of both OAB and PBS/IC is unclear, the influence of environmental factors has been suggested. Both are chronic conditions with very variable symptom resolution and response to therapy. The relationship with voiding dysfunction, gynaecological causes of chronic pelvic pain or the possible alteration of the hypothalamic-pituitary-adrenal axis and psychological disorders has not been established. Inflammation has been suggested as the common link between OAB and BPS/IC.
  
  
  CONCLUSIONS
  OAB and BPS/IC are different symptoms complexes that share urgency as a common symptom. None of them have a specific symptom although pain on bladder filling is the hallmark symptom in BPS/IC. Bladder pain with urgency should be a trigger for referral to the provider with appropriate knowledge and expertise in this disease state, whereas the management of OAB should be part of normal routine care in the community.
authors.affiliation: Servicio de Urologia, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Castro-Diaz
authors.forename: L
authors.initials: L
authors.lastname: Cardozo
authors.forename: C R
authors.initials: CR
authors.lastname: Chapple
authors.forename: M
authors.initials: M
authors.lastname: Espuña
authors.forename: C
authors.initials: C
authors.lastname: Kelleher
authors.forename: M
authors.initials: M
authors.lastname: Kirby
authors.forename: I
authors.initials: I
authors.lastname: Milsom
authors.forename: K-D
authors.initials: KD
authors.lastname: Sievert
authors.forename: A
authors.initials: A
authors.lastname: Tubaro
mesh_terms: D018856:Cystitis, Interstitial / Q000209:etiology*; D018450:Disease Progression; D004777:Environment; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005831:Genital Diseases, Female / Q000150:complications; D006801:Humans; D010147:Pain Measurement; D012742:Sex Offenses; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology; D053201:Urinary Bladder, Overactive / Q000209:etiology*; D053202:Urinary Incontinence, Urge / Q000209:etiology*