Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • food or stress triggers
  • urinary urgency
  • urinary frequency
  • urinary incontinence
  • nocturia
  • dysuria
  • pelvic-floor pain
  • dyspareunia
  • worsening of symptoms before menses
  • urethral pain
  • bladder neck pain
  • suprapubic pain
  • levator ani pain
  • pain after placement of Foley catheter

Other diagnostic factors

  • fibromyalgia
  • vulvar vestibulitis
  • vulvodynia
  • features of SLE
  • migraine
  • features of rheumatoid arthritis
  • features of chronic fatigue syndrome
  • allergies
  • sexual/domestic abuse
  • scrotal or anal pain

Risk factors

  • age 20 to 60 years
  • female gender
  • white ethnicity
  • positive FHx
  • sexual or domestic abuse

Diagnostic investigations

1st investigations to order

  • urinalysis with microscopy and culture
  • vaginal wet prep
  • voiding diary
  • urine cytology
Full details

Investigations to consider

  • cystoscopy with hydrodistention of bladder
  • bladder biopsy
Full details

Emerging tests

  • stress protein gene assay
  • urine antiproliferative factor
  • urine nerve growth factor (NGF)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor and Chairman

Department of Urology

Oakland University William Beaumont School of Medicine

Chair

Department of Urology

Beaumont Health System

Royal Oak

MI

Disclosures

KMP declares that he has worked as a consultant/Investigator for Medtronic, Inc, as a consultant/investigator for StimGuard, Inc., as a consultant for Allergan, and as a consultant for Taris, Inc.‚Äč

Fellow

Female Pelvic Medicine and Reconstructive Surgery

Department of Urology

Beaumont Health System

Royal Oak

MI

Disclosures

NG declares that she has no competing interests.

Dr Kenneth M. Peters and Dr Natalie Gaines would like to gratefully acknowledge Dr Serge P. Marinkovic, Dr Robert Moldwin, Dr Stuart L. Stanton, Dr Lisa M. Gillen, Dr Christina Marinkovic, and Dr Michael Ehlert, the previous contributors to this monograph. SPM, RM, SLS, LMG, CM, and ME declare that they have no competing interests.

Peer reviewers VIEW ALL

Assistant Professor

Director of Female Urology and Urodynamics

University of Minnesota

Minneapolis

MN

Disclosures

NN declares that she has no competing interests.

Urologist

Touro Medical Office

New Orleans

LA

Disclosures

NB declares that he has no competing interests.

Professor of Medicine

Department of Clinical Physiology

Division of Medicine

Whittington Campus

University College London Medical School

London

UK

Disclosures

JML declares that he has no competing interests.

Director

The Urogynecology Center

Overland Park

KS

Disclosures

CB declares that he has no competing interests.

Use of this content is subject to our disclaimer