Your assessment before referral:
Perform a vaginal examination to identify presence of pelvic organ prolapse or pelvic mass. If no prolapse is detected it may be useful to repeat the examination with the woman in a standing position or to ask her to book another appointment to repeat the examination at a different time (the end of the day and/or when she knows her symptoms are likely to be worse).
All patients presenting with associated urinary incontinence/symptoms should undertake a urine dipstick screening to detect the presence of blood, glucose, protein, leucocytes and nitrites in the urine.