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


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).