Transcription of Interstitial Cystitis Questionnaire
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Interstitial Cystitis Questionnaire
Never Occasionally Usually Always0 1 2 3 4 Symptom ScoreBother ScoreHow many times do you urinate dur-ing the waking hours?How many times do you get out of bed to urinate?If you get up at night to urinate, to what extent does it usually bother you?Are you currently sexually active?YesNoIf you are sexually active, do you now or have you ever had pain or urgency to urinate during or after sexual intercourse?Has pain or urgency ever made you avoid sexual intercourse?Do you have pain associated with your bladder or in your pelvis (vagina, lower abdomen, urethra, perineum)?Do you still have urgency shortly after urinating?
Never Occasionally Usually Always 0 1 2 3 4 Symptom Score Bother Score How many times do you urinate dur-
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