Case Study Pelvis and Perineum

Presentation/History
A farmer's wife, 42 years old, comes to the outpatient department with the following complaints. She has a bearing down sensation in her womb, "something seems to come down." This discomfort increases when she strains or lifts heavy loads. She often has backaches, particularly if she is on her feet all day. She also complains of urinary symptoms, such as frequency of and burning on urination. She fatigues easily. The patient has had four children and two miscarriages. Her menstrual flow is increased and her periods are somewhat irregular.