Diagnosing chronic pelvic pain of bladder origin.

Recent data show that in the significant majority of gynecologic patients, chronic pelvic pain (CPP) has its origin in the bladder in the chronic disease process known as interstitial cystitis (IC). IC can produce pain that is perceived in any location or locations in the pelvis in any combination, with or without urinary frequency/urgency. Until recently, the diagnosis of IC was complicated by the variable clinical presentation of the disease and a lack of diagnostic tools. With recent advances in the understanding of the disease, IC's distinctive symptom complex has become well known, and new diagnostic tools are available. Gynecologists can now test CPP patients for the presence of IC using a simple questionnaire, the Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale, and a minimally invasive, office-based procedure, the potassium sensitivity test (PST). Along with a careful history attuned to the characteristic clinical presentation of IC, the PUF Scale and PST can help the gynecologist establish the diagnosis and offer appropriate treatment promptly. IC can be treated very successfully in the majority of cases.