Equilibria
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Bladder Pain-Interstitial Cystitis Symptom Score

Please indicate your responses.

In the past 7 days:

All fields marked * are required fields and must be completed.
When you urinated, how often was it because of pain in your bladder?
 
 
 
 
 
How often did you still feel the need to urinate just after you urinated?
 
 
 
 
 
How often did you urinate to avoid pain in your bladder from getting worse?
 
 
 
 
 
How often did you have a feeling of pressure in your bladder?
 
 
 
 
 
How often did you have pain in your bladder?
 
 
 
 
 
How bothered were you by frequent urination during the daytime?
 
 
 
 
 
How bothered were you by having to get up during the night to urinate?
 
 
 
 
 
Select the number which best describes your worst bladder pain in the past 7 days
 
 
 
 
 
 
 
 
 
 
*

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