A diagnosis of<unk> /BPS is one of exclusion, as well as a review of clinical symptoms. The American Urological Association Guidelines recommend starting with a careful history of the person, physical examination and laboratory tests to assess and document symptoms of<unk> , as well as other potential disorders. The KCl test, also known as the potassium sensitivity test, is no longer recommended. The test uses a mild potassium solution to evaluate the integrity of the bladder wall. Though the latter is not specific for<unk> /BPS, it has been determined to be helpful in predicting the use of compounds, such as pentosan polysulphate, which are designed to help repair the GAG layer. For complicated cases, the use of hydrodistention with cystoscopy may be helpful. Researchers, however, determined that this visual examination of the bladder wall after stretching the bladder was not specific for<unk> /BPS and that the test, itself, can contribute to the development of small glomerulations (petechial hemorrhages) often found in<unk> /BPS. Thus, a diagnosis of<unk> /BPS is one of exclusion, as well as a review of clinical symptoms. In 2006, the ESSIC society proposed more rigorous and demanding diagnostic methods with specific classification criteria so that it cannot be confused with other, similar conditions. Specifically, they require that a person must have pain associated with the bladder, accompanied by one other urinary symptom. Thus, a person with just frequency or urgency would be excluded from a diagnosis. Secondly, they strongly encourage the exclusion of confusable diseases through an extensive and expensive series of tests including (A) a medical history and physical exam, (B) a dipstick urinalysis, various urine cultures, and a serum PSA in men over 40, (C) flowmetry and post-void residual urine volume by ultrasound scanning and (D) cystoscopy. A diagnosis of<unk> /BPS would be confirmed with a hydrodistention during cystoscopy with biopsy. They also propose a ranking system based upon the physical findings in the bladder. People would receive a numeric and letter based score based upon the severity of their disease as found during the hydrodistention. A score of 1–3 would relate to the severity of the disease and a rating of A–C represents biopsy findings. Thus, a person with 1A would have very mild symptoms and disease while a person with 3C would have the worst possible symptoms. Widely recognized scoring systems such as the O'Leary Sant symptom and problem score have emerged to evaluate the severity of<unk>  symptoms such as pain and urinary symptoms. Differential diagnosis The symptoms of<unk> /BPS are often misdiagnosed as a urinary tract infection. However,<unk> /BPS has not been shown to be caused by a bacterial infection and antibiotics are an ineffective treatment.<unk> /BPS is commonly misdiagnosed as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men, and endometriosis and uterine fibroids (in women).
Interstitial cystitis
Bladder cancer
Hemorrhagic cystitis
Endometriosis
Eosinophilic cystitis
Urinary tract infection
Emphysematous cystitis
Prostatitis