Irritative voiding symptoms in women are most often due to uncomplicated urinary tract infection. A cost-effective approach to the treatment of urinary tract infections is a reasonable first step. However, in patients who have persistent or frequently recurrent symptoms, a more thorough evaluation is warranted. These women may be found to have interstitial cystitis, requiring further evaluation. While interstitial cystitis remains a difficult disease to treat, a multi-modality therapy provides excellent symptom relief.