Patients with chronic pelvic pain: endometriosis or interstitial cystitis/painful bladder syndrome?
BACKGROUND
Endometriosis and interstitial cystitis/painful bladder syndrome share similar symptoms. Interstitial cystitis was once considered rare, but it is now recognized as more common than previously thought. This review examines evidence that patients presenting with symptoms typically attributed to endometriosis or with unresolved pelvic pain after treatment for endometriosis may, in fact, have interstitial cystitis, and suggests approaches for appropriate diagnosis.


METHODS
A MedLine search using "chronic pelvic pain," "endometriosis," "interstitial cystitis," and "bladder origin pain" as key words was performed for the most recent English-language articles. Additional references were obtained through cross-referencing the bibliography cited in each publication.


CONCLUSIONS
The symptoms of endometriosis and interstitial cystitis frequently overlap, and these 2 conditions may even coexist in the same patient. In cases of unresolved endometriosis and persistent pelvic pain, patients may have interstitial cystitis. A variety of tools are available to aid in identifying interstitial cystitis.


CONCLUSIONS
Gynecologists should be alert to the possible presence of interstitial cystitis in patients who present with chronic pelvic pain typical of endometriosis.
Butrick
Charles W
CW
The Urogynecology Center, Overland Park, Kansas 66215, USA. CButrick@aol.com
D002908:Chronic Disease; D018856:Cystitis, Interstitial / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003558:Cystoscopy; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013577:Syndrome