title: How do patients with interstitial cystitis present?
abstract: OBJECTIVE
  We determined how interstitial cystitis progresses from initial symptoms to diagnosis.
  
  
  METHODS
  We retrospectively analyzed the records of 45 patients to determine the dates of symptom onset and diagnosis, and sequence of urgency/frequency, nocturia and pain. We also documented alternate and previous diagnoses, and previous surgical treatments.
  
  
  RESULTS
  Of the patients 89% presented with only 1 symptom. Median time from the initial symptom to all symptoms was 2 years (mean 5.5). The most common previous diagnoses were urinary infection in 19 cases, a gynecologic diagnosis in 14 and urethral diagnoses in 6. A previous urinary infection was documented in only 1 of 19 patients, while 11 had undergone hysterectomy and 5 diagnosed with endometriosis had no pathological documentation available.
  
  
  CONCLUSIONS
  Early interstitial cystitis presents variably and usually with only a single symptom of urgency/frequency, nocturia or pain. Clinicians may fail to appreciate the symptoms of early interstitial cystitis, which leads to delayed diagnosis until the patient is more symptomatic. With time multiple symptoms manifest. Bacterial cystitis, prostatitis, endometriosis and chronic pelvic pain are common initial misdiagnoses. Interstitial cystitis should be considered when laboratory documentation of alternate diagnoses is lacking or when patients fail to respond to therapy for alternate diagnoses.
authors.affiliation: Division of Urology, University of Texas Health Science Center-San Antonio, San Antonio, Texas, USA.
authors.forename: A
authors.initials: A
authors.lastname: Driscoll
authors.forename: J M
authors.initials: JM
authors.lastname: Teichman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018856:Cystitis, Interstitial / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors