Symptom checklist
Any of the symptoms below are not normal and may suggest a pelvic floor problem.
Urinary incontinence symptoms
- involuntary leakage on effort or exertion, or on sneezing or coughing (stress urinary incontinence)
- involuntary leakage accompanied by or immediately preceded by urgency (urge urinary incontinence)
- involuntary leakage that occurs without provocation and without awareness (insensible urinary incontinence)
Bladder storage symptoms
- increased daytime urinary frequency
- the interruption of sleep one or more times because of the need to empty your bladder (nocturia)
- urinary urgency (with or without urge incontinence) usually with frequency and nocturia (overactive bladder)
Voiding symptoms
- a delay in initiating the flow of urine
- a slow urinary stream
- urine flow that stops and starts during voiding
- straining to fully empty your bladder
- a feeling of incomplete bladder emptying
- a need to immediately re-void
- an involuntary leak of urine after you’ve finished emptying your bladder
- a need to adopt a specific position to improve bladder emptying, e.g., leaning forwards or backwards or voiding in the semi-standing position
Prolapse symptoms
- the feeling of a vaginal bulge or a heavy, dragging sensation in the suprapubic area and/or pelvis
- difficulty emptying the bladder or rectum sometimes accompanied by the need to apply manual pressure to the vagina, rectum or perineum to assist voiding or defecation
- a low, sacral ‘‘period-like’’ pain often worse at the end of the day or after a lot of activity
Symptoms of sexual dysfunction
- pain or discomfort on vaginal entry or at the vaginal opening (provoked local vestibulodynia- also called superficial dyspareunia or vulvar vestibulitis
- pain or discomfort on deeper penetration (deep dyspareunia)
- vaginal penetration is not possible due to muscle spasm
Symptoms of anorectal dysfunction
- bulging of the rectum beyond the margin of the anus (rectal prolapse)
- feeling that the rectum does not feel empty after defecation
- constipation-infrequent and/or incomplete bowel movements and/or a need for frequent straining or manual assistance to defecate
References
Abrams et al. Review article. Fourth International Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and Treatment of Urinary Incontinence, Pelvic Organ Prolapse, and Fecal IncontinenceNeurourology and Urodynamics 29:213–240 (2010)
Haylen et al. Review article. An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Floor Dysfunction. Neurourology and Urodynamics 29:4–20 (2010).