Interstitial cystitis (bladder pain syndrome)

Case history

A 33-year-old woman presents with a history of experiencing sudden, strong urges to urinate without incontinence since the age of 14 years and with concomitant pelvic pain from the age of 22 years. She has been evaluated by several urologists/gynecologists and has undergone multiple cystoscopies and laparoscopies. She has previously had diagnoses of endometriosis, menorrhagia, recurrent bacterial cystitis, and chronic pelvic pain. All urine cultures were negative and transvaginal ultrasounds were noncontributory. Her 3-day voiding diary demonstrates 18 to 25 voids per 24 hours, with 4 to 8 voids after bedtime. Fluid intake was reasonable at 2 litres.