Warren, John W, Wesselmann, Ursula, Morozov, Vadim et al. · Urology · 2011 · DOI
This study looked at whether having multiple conditions alongside bladder pain (like fibromyalgia, chronic fatigue syndrome, and allergies) increases the risk of developing interstitial cystitis/painful bladder syndrome (IC/PBS). Researchers found that people who had more of these accompanying conditions before developing IC/PBS were at higher risk, and that these conditions often appeared before the bladder symptoms started. The specific types of conditions varied, but their number seemed to matter most.
This research is highly relevant to ME/CFS because chronic fatigue syndrome is identified as one of the key syndromes clustering with IC/PBS, suggesting shared underlying pathophysiological mechanisms. The observation that multiple functional somatic syndromes—including ME/CFS—frequently co-occur and precede IC/PBS development may provide clues to understanding the broader pathogenesis of ME/CFS and related central sensitization conditions. Understanding whether these syndromes share a common cause versus triggering one another sequentially could inform prevention and treatment strategies for this patient population.
This case-control study establishes association but cannot prove causation or determine whether antecedent NBSs directly cause IC/PBS development. The study cannot distinguish between the two proposed hypotheses (sequential cascade versus shared common pathogenesis) and does not establish the biological mechanisms linking these syndromes. Additionally, the study was limited to women and incident cases, so findings may not generalize to men or chronic prevalent IC/PBS cases.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Warren, John W, Wesselmann, Ursula, Morozov, Vadim, & Langenberg, Patricia W (2011). Numbers and types of nonbladder syndromes as risk factors for interstitial cystitis/painful bladder syndrome.. Urology. https://doi.org/10.1016/j.urology.2010.08.059
BibTeX
@article{mecfsatlas-warren-2011-numbers-types,
author = {Warren, John W and Wesselmann, Ursula and Morozov, Vadim and Langenberg, Patricia W},
title = {Numbers and types of nonbladder syndromes as risk factors for interstitial cystitis/painful bladder syndrome.},
journal = {Urology},
year = {2011},
doi = {10.1016/j.urology.2010.08.059},
note = {PubMed: 21295246},
url = {https://www.mecfsatlas.com/evidence/warren-2011-numbers-types},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/warren-2011-numbers-types
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