Figure1 diagnostic algorithm- a useful “aide memoire” for pelvic symptoms and surgical guide.

Each symptom even if occurs only “sometimes”, is ticked in the appropriate box.

Symptoms are associated with specific ligaments (numbers 1-4) and prolapses. The symptoms in the red rectangle can all be caued by USL (uteroacral ligament) weakness or laxity.

The size of the box indicates probability of association with a particular prolapse or ligament.

Some ligaments can cause multiple symptoms. 3 symptoms are uniquely caused by one ligament; stress urinary incontinence : PUL (pubourethral); Nocturia and chronic pelvic pain: USL (uterosacral).