Pelvic symptoms can be categorized in different ways.
According to the:
Standardisation of terminology of pelvic floor muscle function & dysfunction Report From the Pelvic Floor Clinical Assessment Group of the International Continence Society (ICS)
Messelink et al. Neurourology and Urodynamics 2005; 24:374-380.
Pelvic symptoms are categorized as:
- Bladder (lower urinary tract) symptoms
- Urinary incontinence
- stress incontinence – leak with cough, sneeze, laugh, run, jump
- overactive bladder – leak with sudden urge, can’t get there in time, bedwetting
- post micturition dribble – few drops lost without sensation after a wee
- Urgency and frequency – needing to go now, or very often, waking at night to empty
- Slow or intermittent stream and straining – hesitancy or stop / start, or can’t get the flow going
- Incomplete emptying – needing to go back a short while later, with another wee, may be good or rather small volume, possibly resulting in recurrent bladder infections
2. Bowel symptoms
- Obstructed defaecation – it’s there, but it won’t come out
- Functional constipation – it hasn’t even arrived yet
- Faecal incontinence – loss of solid liquid or gas, or soiling (skid-marks)
- Anal fissure – tight anal sphincter, resulting in tearing (like dry lips that crack when you smile, a tight sphincter can ‘split’ when it stretches)
3. Vaginal symptoms
- Pelvic organ prolapse – something hanging low, an aching dragging sensation at the end of the day or after lifting
4. Sexual function
- Women – pain with sex either deep or superficial, not able to have sex, lack of sensation, orgasmic dysfunction
- Men – erectile and ejaculatory dysfunction and pain, orgasmic dysfunction
- Chronic pelvic pain
- Pelvic pain syndrome
Not in Messelink
- Musculoskeletal or somatic pain – low back pain, buttock pain, coccyx pain, hip pain, groin pain, pubic pain, abdominal pain, pregnancy-related pelvic girdle pain
A more recent report categorizes female pelvic symptoms slightly differently, namely:
An International Urogynecological Association (IUGA)/ International Continence Society (ICS) joint report on the Terminology for the conservative and non-pharmacological management of female pelvic floor dysfunction
Bo et al. Neurourol Urodynam 2017; 36: 221–244.
Pelvic symptoms categorized into:
- Urinary incontinence (UI) symptoms
- Bladder storage symptoms
- Sensory symptoms
- Voiding and after voiding (post micturition) symptoms
- Pelvic organ prolapse (POP) symptoms
- Symptoms of sexual dysfunction
- Symptoms of bowel (ano-rectal) dysfunction
- Lower urinary tract infection (UTI)
- Lower urinary tract pain and/or other pelvic pain:
- Pain (in general): “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”.
- Tenderness: sensation of discomfort with or without pain; discomfort elicited through palpation, indicates unusual sensitivity to pressure or touch.
- Acute pain: pain related to acute trauma, infection or other well-defined disease processes or conditions.
- Chronic pain: persistent or continuous/recurrent pain for at least 6 months. If non-acute and central sensitization pain mechanisms are well documented, then the pain may be regarded as chronic, irrespective of the time period.
- Myalgia: muscle pain. Pelvic floor myalgia may be present with or without a change in pelvic floor muscle tone.
- Myofascial pain: pain caused by the presence of trigger points within muscles or their fascia.