Have you ever felt like you have recurrent bladder infections but do not seem to be staying healthy after a course of antibiotics? Have you ever had pain in your pelvis or pain with intercourse that your doctor could not explain?
Causes of chronic pelvic pain and bowel and bladder dysfunction were once thought to be unrelated. We now understand that causes of pelvic pain and /or organ dysfunction sometimes cannot be determined with conventional evaluation.
If you score above 10 on the following questionnaire you likely need further evaluation.
|0||1||2||3||4||症狀指數 Symptom Score||困擾指數 Bother Score|
|1.||日間去多少次小便？ How many times do you urinate during the day?||3-6次||7-10次||11-14次||15-19次||20+次|
|2.||a) 夜間去多少次小便？How many times do you urinate at night?||0次||1次||2次||3次||4+次|
|b) 夜間起床小便，對你是否困擾？ If you get up at night to urinate does it bother you?||不會 Never||偶爾覺得 Occasionally||時常覺得 Usually||隨時感覺困擾 Always|
|3.||你的性生活活躍嗎？ Are you sexually active?||_____ 是Yes ______否No|
|4.||a) 假如你的性生活活躍，性行為前後是否有疼痛或不適症狀？If you are sexually active, do you now or have you ever had pain or symptoms during or after intercourse?||不會 Never||偶爾會 Occasionally||時常 Usually||隨時伴隨 Always|
|b) 假如你感到疼痛，是否會使你避免性行為？If you have pain does it make you avoid sexual intercourse?||不會 Never||偶爾會 Occasionally||時常 Usually||隨時伴隨 Always|
|5.||你的膀胱、盆腔、陰道、下腹部,、尿道、或會陰部是否有疼痛？Do you have pain associated with bladder or in your pelvis, vagina, lower abdomen, urethra or the perineum?||不會 Never||偶爾會 Occasionally||時常 Usually||隨時伴隨 Always|
|6.||若產生疼痛,通常是… If you have pain, is it…||輕微疼痛 Mild||中度疼痛 Moderate||嚴重疼痛 Severe|
|疼痛對你造成困擾？ Does your pain bother you?||不會 Never||偶爾 Occasionally||經常 Usually||一直感覺困擾 Always|
|7.||小便後還有尿急的感覺嗎？ Do you have urgency after urinating?||不會 Never||偶爾會 Occasionally||時常 Usually||隨時伴隨 Always|
|8.||若有尿急感，通常是… If you have urgency is it…||輕微疼痛 Mild||中度疼痛 Moderate||嚴重疼痛 Severe|
|尿急是否造成困擾？ Does your urgency bother you?||不會 Never||偶爾會 Occasionally||時常 Usually||隨時伴隨 Always|