At least two distinct experiences of urge to urinate are evident in this population. For most, urge is linked with pain relief and is associated with bladder filling/emptying. About 1/5 reported urge to prevent incontinence. A similar portion did not agree with either urge, indicating that they may experience something altogether different, which requires further inquiry.

OBJECTIVE To assess how many patients with interstitial cystitis/painful bladder syndrome (IC/PBlS) obtain medical care soon after symptom onset, and to determine how these patients differ from those who have medical care later. PATIENTS AND METHODS In a risk‐factor study of IC/PBlS, we recruited women with IC/PBlS symptoms of ≤12 months’ duration and carefully identified the onset date, first medical encounter and early clinical findings. RESULTS Of 138 women with IC/PBlS for ≤12 months, 49% sought medical care within 7 days and another 31% within 4 weeks. These patients had no easier access to medical care but rather experienced symptoms differently, with more evidence for discomfort and inflammation. However, subsequently they did not differ from those with more gradual onset in features indicative of IC/PBlS, i.e. Hunner’s ulcers, petechial haemorrhages, symptoms, medications, or quality of life. CONCLUSIONS A shorter time to the first medical encounter was not a function of greater access to medical care but instead was associated with more discomfort and evidence of inflammation, as distinct from those with more gradual onset. The 6‐month follow‐up of both groups indicated that no significant differences in IC/PBlS symptoms persisted. A careful study of rapid‐onset IC/PBlS might provide clues to the pathogenesis of this enigmatic disease.