A lot of information can be obtained by completing an external pelvic floor evaluation but a more complete clinical picture is obtained with the completion of an internal pelvic floor muscle exam. (hab-it.com)
«We are still lacking a clear clinical picture because there have been no long term prospective studies of the disease spectrum from diagnosis to death,» write the authors. (sciencedaily.com)
There is quite a bit here, and I don't have a great grasp on your whole clinical picture, but here are some thoughts. (tctmed.com)