Pelvic Floor Screening Tool
Do you now have or have you had a history of the following?
- Bladder infection
- Low back pain
- Sexually Transmitted Disease
- Pelvic pain
- Abdominal pain
- Smoking habit
Do you have trouble making it to the toilet in time?
Do you lose urine when you have a strong urge to urinate?
Do you lose urine with any of the following?
- Coughing or sneezing
- Active exercise (running, etc.)
- Minimal exercise (walking, housework)
- Nervousness or increased anxiety
- Leakage unrelated to any specific cause
Do you experience wet clothing with a few drops, wet underwear, wet outer clothes, or a wet floor?
Do you use sanitary pads, tissue paper or diapers for protection? Are they damp, wet or saturated at each change?
Do you empty your bladder frequently, before you experience the desire to pass urine, just so you stay dry?
Do you have any bowel or gas control problems?
If you answered yes to any of the above questions, you may benefit from Pelvic Floor Rehabilitation Therapy.
For more info, please call (714) 771-8222 or e-mail Kathy Berger, Director of Rehabilitation Services, at firstname.lastname@example.org.