Symptom Scoring Helps Flag Interstitial Cystitis.

CHICAGO -- As many as one in three women with chronic pelvic pain may have interstitial cystitis, and a simple symptom scoring system may help identify them.

"Among women with chronic pelvic pain, 30%-60% may have normal findings on laparoscopy, suggesting other possible sources for their pain," Dr. Jeffrey Clemons said at the annual meeting of the American College of Obstetricians and Gynecologists.

Physicians often don't look for interstitial cystitis (IC) in patients with chronic pelvic pain because its incidence in this population is unknown. It therefore ranks further down the list of other possible diagnoses such as endometriosis, adhesions, ovarian cysts, and fibroids, Dr. Clemons of Women and Infants Hospital of Rhode Island in Providence, explained in an interview.

A symptom scoring system known as the Interstitial Cystitis Symptom and Problem Index can help identify women with IC. The system involves a validated questionnaire that was first developed in 1997 to evaluate urinary tract symptoms in women with an established diagnosis of IC. The index measures symptoms of urgency, frequency, and nocturia.

Dr. Clemons and his colleagues studied 45 women scheduled to undergo Iaparoscopy for chronic pelvic pain to see if the symptom index could be used to screen for IC among these patients. The investigators found that the index, when used along with a dyspareunia visual analog scale, helped identify IC in 38%.

In addition to laparoscopy, all the women underwent cysroscopy with hydrodistention to confirm the presence or absence of IC.

The diagnosis of IC required participants to have symptoms of urgency, frequency, or nocturia, as well as positive cystoscopy, defined as 10 or more glomerulations per quadrant ...