Do i seriously have to have surgical cystoscopy for my doctor to diagnose interstitial cystitis?

No: Not unless you've tried all the basic stuff like diet first. Your doc should always try that first. The aua has a protocol and cysto is about 1/2way through. Try ichelp.Org the american urologic association has made clear that cystoscopy with hydrodistention does play a role, its just later down the line for non-responders. Some patients even get soem relief with it.

No: Ic or painful bladder syndrome (pbs) is a constellation or collection of symptoms including pelvic and bladder symptoms. In the past, cystoscopy was a big part of the diagnosis, but adds little value today. If you have blood in the urine or recurrent bacterial bladder infections, then the cystoscopy may be of some benefit.