Commentary on the article by I.V. Kuzmin and M.N. Slesarevskaya “Hypersensory bladder disease: concept and pathogenetic basis”

Overactive bladder (OAB) and primary bladder pain syndrome (PBPS) are among the most common lower urinary tract dysfunctions. The authors note the similarities between many aspects of OAB and PBPS, particularly their pathogenesis, symptoms, and clinical course. Thus, similar infectious and non-infectious factors may play a role in the development of these conditions. The authors’ assertion that the insufficient effectiveness of standard therapy in patients with OAB and PBPS may be due to its limited effect on the afferent signaling system responsible for bladder hypersensitivity, chronic bladder wall inflammation, which maintains high levels of afferent activity, and central sensitization, which makes pharmacotherapy acting at the bladder level ineffective. The authors proposed the concept of hypersensory bladder disease, which combines the hypersensory phenotypes of OAB and PBPS. This concept is not without controversy, but it deserves close attention and further study, as it will allow for individualized treatment and tailored therapy based on the pathogenetic and clinical characteristics of these conditions.