Cozean Pelvic Dysfunction Screening Protocol

Do any of these apply to you?

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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

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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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