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Your Pelvic Health Profile - Prolapse Questions

This questionnaire asks relevant questions to find out whether you have prolapse symptoms or not. The questions focus on prolapse and vaginal laxity symptoms and their effects on your day to day life.

The questions are adapted from the Australian Pelvic Floor Questionnaire.

Click the button below to start.

Start

Question 1 of 6

Do you have a sensation of tissue protrusion / lump / bulging in your vagina?

A

Never

B

Occasionally - less than once per week

C

Frequently - once or more per week

D

Daily

Question 2 of 6

Do you experience vaginal pressure or heaviness or a dragging sensation?

A

Never

B

Occasionally - less than once per week

C

Frequently - once or more per week

D

Daily

Question 3 of 6

Do you have to push back your prolapse in order to void (empty bladder)?

A

Never

B

Occasionally - less than once per week

C

Frequently - once or more per week

D

Daily

Question 4 of 6

Do you have to push back your prolapse in order to empty your bowels?

A

Never

B

Occasionally - less than once per week

C

Frequently - once or more per week

D

Daily

Question 5 of 6

How much does your prolapse problem bother you?

A

Not at all

B

Slightly

C

Moderately

D

Greatly

Question 6 of 6

Would you like to add any experiences or symptoms relating to the prolapse that have not already been covered in the previous questions?

Confirm and Submit