title: Chiropractic management of pubic symphysis shear dysfunction in a patient with overactive bladder.
abstract: OBJECTIVE
  The purpose of this case report is to describe chiropractic management of a patient with overactive bladder (OAB) and to describe an hypothetical anatomical basis for a somato-vesical reflex and possible clinical link between pelvic and symphysis pubis dysfunction to OAB.
  
  
  METHODS
  A 24-year-old nulliparous female with idiopathic OAB, with a primary complaint of nocturia presented for chiropractic care. Her sleep was limited to 2 consecutive hours due to bladder urgency. Pubic symphysis shear dysfunction was observed on physical examination.
  
  
  RESULTS
  The primary treatment modality used was chiropractic side-posture drop-table manipulation designed to reduce pubic shear dysfunction. After 8 treatments in 1 month, the pubic shear gradually reduced while nocturia diminished and consecutive sleep hours increased from 2 to 7. At 1-year follow-up, the nocturia remained resolved.
  
  
  CONCLUSIONS
  The patient reported in this case responded favorably to chiropractic care, which resulted in reduced nocturia and increased sleep continuity.
authors: Professor, Director of Research and Technique, Palmer Chiropractic College, San Jose, CA.
authors: Robert
authors: R
authors: Cooperstein
authors: Staff Chiropractor, VA Connecticut Healthcare System, West Haven, CT.
authors: Anthony
authors: A
authors: Lisi
authors: Research Assistant, Palmer College of Chiropractic West, San Jose, CA.
authors: Andrew
authors: A
authors: Burd
keywords: Manipulation, chiropractic; Manipulation, osteopathic; Pubic symphysis; Pubic symphysis diastasis; Symphysis pubis dysfunction; Urinary bladder, overactive