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To optimally treat patients with a more complex presentation and/or when standard treatment approaches are ineffective, urologists may need to partner with other clinicians such as primary care providers, nurse practitioners, registered dietitians, physical therapists, pain specialists, gastroenterologists, and/or gynecologists

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233, 237-239 These factors often coexist and point unequivocally to a bladder source of symptoms

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However, this approach frequently fails to address the underlying "hardware" failurethe cellular and subcellular pathology resulting from the neurometabolic cascade of injury