Interstitial cystitis (bladder pain syndrome)

Pelvic Pain and Urgency/Frequency (PUF) Questionnaire

There are no screening programs. However, simple, validated questionnaires, such as the PUF Questionnaire, may be used by the general medical community to identify high-risk patients.[41]Parsons CL, Dell J, Stanford EJ, et al. Increased prevalence of interstitial cystitis: previously unrecognized urologic and gynaecologic cases identified using a new symptom questionnaire and intravesical potassium sensitivity. Urology. 2002 Oct;60(4):573-8. http://www.ncbi.nlm.nih.gov/pubmed/12385909?tool=bestpractice.com

The PUF scale is a comprehensive symptom questionnaire that evaluates patients for urinary urgency, frequency, pelvic pain, and sex-associated symptoms (e.g., dyspareunia).[41]Parsons CL, Dell J, Stanford EJ, et al. Increased prevalence of interstitial cystitis: previously unrecognized urologic and gynaecologic cases identified using a new symptom questionnaire and intravesical potassium sensitivity. Urology. 2002 Oct;60(4):573-8. http://www.ncbi.nlm.nih.gov/pubmed/12385909?tool=bestpractice.com The score has been validated for screening in a urology clinic setting.[36]Kushner L, Moldwin RM. Efficiency of questionnaires used to screen for interstitial cystitis. J Urol. 2006 Aug;176(2):587-92. http://www.ncbi.nlm.nih.gov/pubmed/16813894?tool=bestpractice.com Screening indices and a detailed history and physical exam used in conjunction with diagnostic tests were effective in excluding other diseases and directing the practitioner to a diagnosis of IC.

Symptom scores of 12 or more suggest IC, and a urology, gynecology, or urogynecology referral may be recommended. However, high scores may still overlap with other urologic diseases, such as overactive bladder and urinary tract infections.

[Figure caption and citation for the preceding image starts]: Pelvic Pain and Urgency/Frequency (PUF) QuestionnaireInterstitial Cystitis Foundation [Citation ends].

Interstitial Cystitis Symptom Index and Problem Index (ICSI-PI)

The most commonly used standardized screening and diagnostic questionnaire is the Interstitial Cystitis Symptom Index and Problem Index, which is also very useful for following patients' treatment response and management.[42]O'Leary MP, Sant GR, Fowler FJ Jr, et al. The interstitial cystitis symptom index and problem index. Urology. 1997 May;49(5A Suppl):58-63. http://www.ncbi.nlm.nih.gov/pubmed/9146003?tool=bestpractice.com ​ It has three composite symptom subscales that monitor the domains of pain/discomfort, urgency, and voiding frequency. A 1.2-point change in the O'Leary-Sant indexes corresponds to a one category change in the global response assessment.[43]Propert KJ, Mayer RD, Wang Y, et al. Responsiveness of symptom scales for interstitial cystitis. Urology. 2006 Jan;67(1):55-9. http://www.ncbi.nlm.nih.gov/pubmed/16413332?tool=bestpractice.com Interstitial Cystitis Symptom Index and Problem Index (ICSI-PI) Opens in new window

Such questionnaires have found their most significant role in the follow-up assessment of patients' symptoms, especially after initiation therapy. They are an effective means of determining objective improvements after medical or surgical therapies.