Nociceptive, afferent C-fibers become
active in response to bladder inflam- mation or irritation, resulting in pain and reflex voiding. A sustained guard- ing reflex manifests as pelvic floor muscle hypertonus (Figures 2 and 3).22 High-tone pelvic floor muscle dysfunction has neurologic and musculoskeletal components. Neuro- modulation therapy attempts to ablate the sustained guarding reflex.