Interstitial cystitis symptoms as defined are indistinguishable from posterior fornix syndrome symptoms cured by uterosacral ligament repair

Objective: To test our hypothesis that female interstitial cystitis (IC) and Posterior Fornix Syndrome (PFS) are one and the same. Materials and Methods: A retrospective study. We extracted raw CPP data from patients who had TFS surgery for cure of uterine/apical prolapse, along with bladder, pad and urodynamic data. We critically compared known IC phenotypes with PFS symptoms to check our hypothesis for truth or falsity. We used a validated Integral Theory System Questionnaire (ITSQ), “simulated operations” testing with the speculum test (which reduces urge and pain if USLs are weak), transperineal ultrasound, urodynamics, surgery and post-operative urodynamics. Results: Forty-six patients with CPP had 157 urinary symptoms. The cure rate was CPP 76%, urge incontinence 74%, abnormal emptying/ retention 80%, nocturia 75%, frequency 50%. Conclusion: PFS data accord exactly with the ICS definitions for IC, except that PFS patients were cured or improved by USL repair, IC patients, not. Further testing of our hypothesis will require wide-ranging testing with the ITSQ (which diagnoses both PFS and IC), and the simulated operations “speculum tests” to confirm that USL weakness is indeed the cause.