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Cozean Pelvic Dysfunction Screening Protocol

Do any of these apply to you?

  1. I sometimes have pelvic pain (in genitals, perineum, pubic or bladder area, or pain with urination) that exceeds a ‘3’ on a 1-10 pain scale, with 10 being the worst pain imaginable

  2. I can remember falling onto my tailbone, lower back, or buttocks (even in childhood)

  3. I sometimes experience one or more of the following urinary symptoms

    • Accidental loss of urine

    • Feeling unable to completely empty my bladder

    • Having to urinate within a few minutes of a previous void (urination)

    • Pain or burning with urination

    • Difficulty starting or frequent stopping/starting of urine stream

  4. I often, or occasionally, have to get up to urinate two or more times at night

  5. I sometimes have a feeling of increased pelvic pressure or the sensation of my pelvic organs slipping down or falling out

  6. I have a history of pain in my low back, hip, groin, or tailbone or have had sciatica

  7. I sometimes experience one or more of the following bowel symptoms

    • Loss of bowel control

    • Feeling unable to completely empty my bowels

    • Straining or pain with a bowel movement

    • Difficulty initiating a bowel movement

  8. I sometimes experience pain or discomfort with sexual activity or intercourse

  9. Sexual activity increases one or more of my other symptoms

  10. Prolonged sitting increases my symptoms

If you agree with 3 or more of the statements above, you may have pelvic floor issues and should contact our office. Book a FREE 15-minute phone consultation with Dr. Carri to find out more about how pelvic floor physical therapy can help you.

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