# Parasympathetic and sympathetic mechanisms underlying bladder nociception

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $352,125

## Abstract

Project Summary
Bladder nociceptive afferents play an important role in painful bladder syndrome/interstitial cystitis (PBS/IC).
Although extensive research has been conducted to understand the involvement of parasympathetic pelvic C-
fiber afferents in bladder nociception, very few studies have investigated the role of sympathetic hypogastric
afferents. Previous animal studies have shown that sympathetic hypogastric afferents respond to bladder
distension and/or irritation. Clinical evidence also supports the role of sympathetic afferents in bladder
sensation/pain because blockade of the sympathetic afferent pathway can significantly relieve visceral pelvic
pain including PBS/IC symptoms and bladder sensation/pain can still be elicited in human subjects with
destroyed sacral spinal cord or transected sacral spinal roots. Since both sympathetic hypogastric nerves and
parasympathetic pelvic nerves innervate the bladder, bladder distention/irritation always activates both
pathways, causing significant difficulty in separating the functions of these two pathways in bladder
nociception. Currently it is still unknown how sympathetic hypogastric afferents interact with the
parasympathetic pelvic afferents in the CNS to modulate bladder function. It is also unknown if sympathetic
hypogastric afferents alone can trigger bladder reflex activity and what role the sympathetic hypogastric
nociceptive afferents play in bladder nociception/overactivity. Without this basic knowledge, our understanding
of bladder nociception is certainly incomplete, which is evident clinically when diagnosing and attempting to
treat PBS/IC. Therefore, in this grant application we propose to determine the functions of both
parasympathetic nociceptive pelvic C-fiber afferents and sympathetic nociceptive/non-nociceptive hypogastric
afferents in the control of bladder reflex activity and to determine the central convergence/interaction between
sympathetic hypogastric afferents and parasympathetic pelvic nociceptive/non-nociceptive afferents. The
success of our project will provide the basic scientific knowledge of bladder nociception and will benefit millions
of Americans suffering from PBS/IC.

## Key facts

- **NIH application ID:** 9843122
- **Project number:** 5R01DK111382-04
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** JONATHAN M BECKEL
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $352,125
- **Award type:** 5
- **Project period:** 2017-01-11 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9843122

## Citation

> US National Institutes of Health, RePORTER application 9843122, Parasympathetic and sympathetic mechanisms underlying bladder nociception (5R01DK111382-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9843122. Licensed CC0.

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