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An hypothesis generated in one IC/PBS patient group and tested in another--pain that worsened with certain food or drink and/or worsened with bladder filling and/or improved with urination--was described by 97% of the patients with IC/PBS in each cohort. This triad might describe the pain of IC/PBS and contribute to a sensitive case definition. Estimating specificity awaits comparison with other diseases with similar symptoms.

Objectives-The case definition of interstitial cystitis (IC) is in flux. The International Continence Society (ICS) suggested a definition for the painful bladder syndrome (PBS), a concept embraced by many IC investigators, some of whom have used the name IC/PBS. In a study of recent onset IC/ PBS patients, we had two objectives: to determine 1) what proportion met the ICS definition and 2) how did those who met the definition differ from those who did not.Methods-Having recruited women who had recent onset IC/PBS for an ongoing case control study to identify its risk factors, we studied our first 138 eligible cases to identify those who met the ICS definition. We then compared those who met the definition to those who did not by variables acquired through interviews and medical records. The most liberal interpretation of the ICS definition did not include 47/138 (34%) of our cases. Comparing these to the 91 (66%) who did meet the ICS criteria, we found that 96/97 clinical variables, including many generally thought characteristic of IC/PBS, were not significantly different between the 2 groups. Results-The

Suprapubic prominence and changes in the voiding cycle are features consistent with but do not prove that the bladder is the pain generator in interstitial cystitis/painful bladder syndrome and the pain sites described by patients are referred from it. The patients with interstitial cystitis/painful bladder syndrome who might have been diagnosed with vulvodynia or urethral syndrome did not differ from others in important patient variables.