“Simulated operation” to support uterosacral ligaments “USL.” 3D view of PUL and USL attachments to the pelvic brim (circle). A gently inserted speculum mechanically supports USLs. “L” indicates USL laxity. Lax USLs (laxity indicated by wavy lines) cannot support the “VPs” and these fire of impulses to the cortex which are interpreted as pain. Wavy lines in the muscles LP and LMA which contract against USLs indicate weakened muscle forces, as a muscle requires a firm insertion USL point to exert optimal force. The wavy form of the vagina indicates looseness; it cannot be stretched sufficiently to support the urothelial stretch receptors “N” which now fire off excess afferents to activate the micturition reflex prematurely. The cortex interprets these impulses as “urge.” The speculum mechanically supports USLs, “N” and stretches vagina to reverse the above processes; the patient reports lessening of pain and urge. LP, levator plate; LMA, conjoint longitudinal muscle of the anus.