Background Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating condition of chronic pelvic pain associated with urinary frequency and comorbid anxiety and depression. Recent studies in IC/BPS patients and rodent models implicate fecal dysbiosis and increased systemic exposure to endotoxin. These changes potentially elicit innate immune responses via the activation of microglial cells in the central nervous system, key mediators of pain. Microglial ablation and inactivation have previously been associated with analgesia in preclinical studies, underscoring the role of microglia in IC/BPS pain. Here, we investigated whether IC/BPS-associated fecal microbiota differentially activate microglia and whether activation correlates with patient symptoms. Methods Microbiome-microglia interactions were assessed using three complementary in vitro culture models: BV2 cells, enriched primary microglia (~ 95% microglia), and mixed glial cultures (microglia and astrocytes). Microglial cultures were exposed to heat-killed, stool-derived microbiota, and the pro-inflammatory cytokines tumor necrosis factor-α (TNF-α), RANTES/CCL5, and interleukin-6 (IL-6) were quantified by ELISA. Cytokine levels were evaluated for patients and controls and correlated with patient-reported genitourinary pain index (GUPI) scores. Results In all culture models, microglia exhibited significantly increased proinflammatory responses to fecal microbiota of IC/BPS patients relative to controls. Mixed glial cultures, incorporating astrocyte-microglia interactions, exhibited the most robust cytokine responses. Cytokine levels positively correlated with GUPI pain scores. Conclusions Together, these findings further support a role for gut dysbiosis in IC/BPS symptoms and suggest microglial activation and glial-glial interactions as a contributing mechanism. Understanding gut-brain axis interactions in IC/BPS will thus enable development of novel microbiome-based therapies for treating IC/BPS patients.

Introduction Chronic low back pain (CLBP) is defined as pain in the lower back that persists for more than three months. It is a common musculoskeletal condition and a major contributor to functional impairment and social limitations among young adults. Hamstring flexibility refers to the ability of the hamstring muscles to stretch to their full length. Since both the hamstrings and lumbar extensor muscles originate from the pelvis, a biomechanical relationship may exist between them. Decreased flexibility or weakness in these muscles may contribute to the development of low back pain. Tight hamstrings, which may result from previous injury or insufficient physical activity, can restrict pelvic mobility and limit movement of the lumbar spine. Such limitations may be associated with repetitive microtrauma, thereby contributing to the development of back pain. This study aimed to examine the association between hamstring tightness and CLBP. Materials and methods A cross-sectional analytical study was performed after obtaining ethical approval. The study included 40 patients diagnosed with CLBP and 40 age-matched healthy individuals who served as controls. Hamstring flexibility was evaluated using the active knee extension (AKE) test and the passive straight leg raising test (PSLRT), conducted on multiple occasions. Anthropometric parameters, including height, weight, and BMI, were also recorded. Statistical analysis of the collected data was carried out using the chi-square test and correlation analysis. The analysis was performed using SPSS version XX (IBM Corp., Armonk, NY). A p-value < 0.05 was considered statistically significant (α = 0.05). Pearson's correlation coefficient was used for normally distributed variables. Results Abnormal findings in the PSLRT were observed in 35 (87.5%) cases on the right side and 32 (80%) cases on the left side. In contrast, among the control group, only five (12.5%) individuals showed abnormal SLRT results on both sides. These differences were statistically significant (right: χ² = 45.00, p < 0.001; left: χ² = 36.10, p < 0.001). The AKE test revealed hamstring tightness on the right side in 35 (87.5%) cases compared to five (12.5%) controls, and on the left side in 33 (82.5%) cases compared to seven (17.5%) controls. These differences were also statistically significant (p < 0.001). The mean age of participants in the case group was 28.50 ± 5.48 years, while the control group had a mean age of 28.28 ± 5.11 years. Most participants were within the 20-40 year age range, a group in which mechanical low back pain is commonly seen. Both the AKE test and PSLRT indicated significantly reduced hamstring flexibility among individuals with CLBP compared to the control group. In addition, a positive correlation was identified between increased height and the presence of hamstring tightness. Conclusions The findings of this study suggest that individuals suffering from CLBP have significantly decreased hamstring flexibility compared to healthy individuals. The study also demonstrated an association between increased height and greater hamstring tightness in both case and control groups.

Background/Objectives: To investigate the therapeutic potential and mechanistic basis of Bao Jing Tablet (BJT) for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) via an experimental autoimmune prostatitis (EAP) rat model, through integrating network pharmacology, metabolomics, proteomics, and animal experiments. Methods: UPLC-ZenoTOF 7600-MS/MS was used to analyze the chemical composition of BJT. The therapeutic effect of BJT was evaluated using an experimental autoimmune prostatitis (EAP) rat model. Lipid metabolomics, proteomics, and integrated network pharmacology analyses were performed to investigate the potential mechanisms and active components of BJT in treatment. Results: A total of 174 constituents were identified in BJT, among which 54 major active compounds were screened for further analysis. Network pharmacology and combined multi-omics analysis indicate that the protein targets of HIF-1α, Akt, and PI3K/Akt, as well as the Glycolysis pathway, play important roles in the improvement of CP/CPPS. Conclusions: Our results demonstrated that BJT was an effective drug to improve the development of CP/CPPS. This is associated with the PI3K/Akt-HIF-1α-Glycolysis pathways.

Endometriosis and endometrial cancer are distinct gynecological conditions that share overlapping biological mechanisms with implications for clinical management. Endometriosis is a chronic, benign disorder characterized by the ectopic implantation of functional tissue lining the uterus, primarily affecting women of reproductive age. It commonly causes chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. The disease is marked by persistent inflammation, hormonal dysregulation, and alterations in cellular signaling, which mirror some neoplastic processes despite lacking malignant potential. Endometrial cancer is a malignant tumor of the uterine lining, most frequently diagnosed in postmenopausal women. Its incidence is rising due to aging, obesity, and prolonged estrogen exposure. Epidemiological studies suggest a modest increase in endometrial cancer risk among women with endometriosis. However, detection bias and metabolic confounders may influence this association. Both conditions share estrogen dependence, chronic inflammatory microenvironments, and dysregulated pathways such as PI3K/AKT/mTOR. Somatic mutations in genes, including PTEN and ARID1A, further underline molecular intersections. Clinical management is tailored to disease type and severity. Endometriosis therapy emphasizes stepwise hormonal treatment, multidisciplinary pain management, and surgery when indicated. Endometrial cancer management relies on staging, with particular emphasis on molecular classification and histopathology to guide surgery, radiotherapy, chemotherapy, hormone therapy, and immunotherapy in advanced cases. Emerging noninvasive biomarkers and precision medicine strategies may enhance diagnosis, monitoring, and targeted treatment in both conditions. Understanding their shared and divergent mechanisms aids risk stratification, individualized therapy, and improved quality of life. Further prospective studies are needed to optimize patient-specific management and translate mechanistic insights into clinical practice.

Purpose: This study compared the therapeutic efficacy of different bladder monotherapies and multimodal therapy in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Materials and methods: In total, 190 patients with a confirmed diagnosis of IC/BPS were treated with different bladder therapies. The bladder monotherapies included intravesical platelet-rich plasma (PRP) injection (n = 60), intravesical botulinum toxin A (BoNT-A) injection (n = 33), intravesical hyaluronic acid (HA) instillation (n = 36), and low-energy shock wave (LESW) bladder therapy (n = 61). Multimodal therapy (MMT) was provided to patients who had unsuccessful initial bladder treatment targeting chronic inflammation, urothelial dysfunction, bladder pain, pelvic floor muscle pain, psychological stress, and lower urinary tract dysfunction. The treatment outcome was assessed using self-reported Global Response Assessment scores at 3 months and during the follow-up time points after bladder treatment. Results: Thirty-one patients received MMT. The 3-month success rates of bladder therapy were 55.0% for PRP injection, 57.6% for BoNT-A injection, 50.0% for HA instillation, 46.7% for LESW bladder therapy, and 58.1% for MMT. The success rates of bladder monotherapy decreased after 6 months. However, the success rate of MMT increased at 9 (67.7%) and 12 (73.1%) months. Patients treated with MMT exhibited improvement in glomerulation grade after cystoscopic hydrodistention. Only patients with successful treatment outcomes after MMT had improvement in bladder pain severity and pelvic floor muscle pain parameters. Conclusions: Bladder monotherapy such as PRP injection, BoNT-A injection, HA instillation, and LESW bladder therapy had successful treatment outcomes in patients with IC/BPS. In patients who had unsuccessful initial bladder therapy, the 3-month success rate of MMT was 58.1% and sustained improvement with time, particularly in the improvement of bladder pain and PFM pain severity.

Endometriosis is a chronic gynecological disorder that affects approximately 10% of women of reproductive age. In adolescents, it frequently remains underdiagnosed due to the heterogeneity of its clinical presentation. Pelvic pain and dysmenorrhea are often interpreted as physiological symptoms associated with the menstrual cycle, which contributes to delayd diagnosis and postpones timely intervention. Current management strategies primarily include nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies, with the dual objective of relieving pain and, in the case of endometriosis, limiting disease progression. Ultrasound and magnetic resonance imaging (MRI) are valuable tools for diagnostic assessment. Laparoscopy may be sometimes required in cases where medical treatment proves ineffective. In adolescents, as in adults, a multidisciplinary approach is strongly recommended. Recent advances have focused on the identification of specific biomarkers and the development of non-invasive diagnostic methods, with the aim of improving early detection and enhancing patients' quality of life. This literature review provides an overview of current diagnostic and therapeutic strategies for endometriosis in adolescents, while exploring innovat.