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 systemic lupus erythematosus
- 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 sex
- white ethnicity
- positive family history
- sexual or domestic abuse
Diagnostic investigations
1st investigations to order
- urinalysis with microscopy and culture
- vaginal wet prep
- voiding diary
- urine cytology
Investigations to consider
- cystoscopy with hydrodistention of bladder
- bladder biopsy
Emerging tests
- stress protein gene assay
- urine antiproliferative factor
- urine nerve growth factor (NGF)
Treatment algorithm
Contributors
Authors
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 for Taris, Inc and Amphora Medical, and as a consultant and equity ownder for SimGuard.
Urology Fellow
Department of Urology
Beaumont Health
Royal Oak
MI
Disclosures
LTÂ declares that she has no competing interests.
Dr Kenneth M. Peters and Dr Lauren Tennyson would like to gratefully acknowledge Dr Natalie Gaines, 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 topic. NG, SPM, RM, SLS, LMG, CM, and ME declare that they have no competing interests.
Peer reviewers
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