Interstitial Cystitis: Medical History

Medical history (history of illness) represents an important component in the diagnosis of interstitial cystitis.

Family history

Social history

• Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

• How often do you need to urinate (including at night)?
• Do you have pain when you urinate?
• Do you feel a burning sensation when you urinate?
• Do you empty only a little urine, although you feel you have a bulging urinary bladder?
• Do you have difficulty holding urine?
• Do you have pain in the lower abdomen?
• Have you noticed blood in your urine?
• Is the urine concentrated or flocculent?
• Do you suffer from stress or constant tension?
• Have you recently worn an indwelling catheter?

Further questions or answers arise from keeping a micturition diary (urinary diary; see below) and a pain diary (pain scale) including urgency.

Vegetative anamnesis incl. nutritional anamnesis.

• Were you exposed to drafts with damp clothing, such as in the swimming pool?
• Do you practice regular but not excessive intimate hygiene?
• Do you drink enough?
• Do you use a vaginal diaphragm for contraception?
• Do you have anal intercourse?
• Do you empty your urinary bladder after sexual intercourse?
• Do you suffer from recurrent urinary tract infections?
• Have you had to undergo chemotherapy and/or pelvic radiotherapy?
• Do you smoke? If yes, how many cigarettes, cigars, or pipes per day?
• Do you drink alcohol? If yes, what drink(s) and how many glasses per day?

Self history incl. medication history.

• Pre-existing conditions (diabetes mellitus (diabetes), urinary tract diseases).
• Operations
• Allergies

Medication history – due to differential diagnosis.

• Antibiotic therapy, 2 to 4 weeks ago.
• Immunosuppressed patient(s).
• Contraception (birth control) with DMPA (depot medroxyprogesterone acetate).
• Cytostatic drugs (e.g. methotrexate).

Notes on keeping a daily diary

A diary (micturition diary, micturition log; urinary diary; bladder diary) should be kept with the following entries for 2-14 days:

• Frequency of micturition (frequency of urination) on 2 days.
• Micturition volume (volume of urination).
  • Morning urine
  • Maximum micturition volume (not including 1st morning urine).
  • Average micturition volume (without taking into account the 1st morning urine).
  • Nocturnal urine volume (1st morning urine + nocturnal urine volume).
• Drinking amount/24 h on 2-3 days
• Time to fall asleep and time to get up
• Complaints such as incontinence (inability to hold back hair), urge or pain.
• Urinary incontinence events (bladder weakness) in 14 days.

Consequently, a micturition calendar contains the columns:

• Date
• Time
• Drinking quantity (ml)
• Urine quantity (ml)
• Incontinence, other

For the doctor

It is also helpful to use standardized questionnaires such as:

• Interstitial Cystitis Symptom Index [ICSI]
• Interstitial Cystitis Problem Index (ICPI).
• Analog pain scale
• 36-Item Short Form Health Survey [SF-36]
• King’s Health Questionnaire
• O’Leary-Sant Interstitial cystitis symptom and problem indices.
• Pelvic Pain and Urgency/Frequency (PUF) patient symptom scale.