Evaluation of IC

The path to diagnosis shouldn't have to take a long time. But for many, the right diagnosis can take months, even years. If you do have interstitial cystitis (IC), the sooner you find out, the faster you can take action.

IC Symptom Questionnaire

The following IC Symptom Questionnaire, also known as the PUF Questionnaire,* measures the symptoms associated with IC, based on pain, urgency, and frequency of urination. Complete all of the questions, print out the results, and then take it to your doctor.

If you’ve already been diagnosed with IC, the IC Symptom Questionnaire can be used as a helpful tool for tracking the progress of your treatment.

Please understand your responses are anonymous (they do not identify you personally) and will not be stored by Janssen Pharmaceuticals, Inc.

IC Symptom Questionnaire

For each question, please select the response that best describes how you feel. Then click the "See Results" button to go to a printable page you can take to your next appointment.

1. How many times do you go to the bathroom during the day?
2. a. How many times do you go to the bathroom at night?
b. If you get up at night to go to the bathroom, does it bother you?
3. Are you currently sexually active?
4. a. If you are sexually active, do you now or have you ever had pain or the urge to urinate during or after sexual intercourse?
b. If you have pain or the urge to urinate, does it make you avoid sexual intercourse?
5. Do you have pain associated with your bladder or in your pelvis (vagina, lower abdomen, urethra, perineum, testes, or scrotum)?
6. a. If you have pain, is it usually:
b. Does your pain bother you?
7. Do you have urgency after going to the bathroom?
8. a. If you feel the urge to urinate, is it usually:
b. Does this urge bother you?

*Developed by C. Lowell Parsons et al; PUF Questionnaire (Pelvic Pain, Urgency, and Frequency) © 2002.