The pictorial diagnostic algorithm represents three zones of connective tissue causation. Positive symptoms (even “sometimes”) are ticked in each column where they occur, and the causative prolapse and ligaments emerge. The prolapses in the algorithm correlate with ligament damage in the columns. Symptom groupings in the 3 columns help to deduce which ligaments cause which symptoms and serve as a guide to surgical repair of the ligaments. Pelvic pain and nocturia are only caused by uterosacral ligament (USL) laxity. Severe stress incontinence is caused mainly by pubourethral ligament (PUL) laxity. Hammock, suburethral vaginal hammock; EUL, external urethral ligament attached to the external urethral meatus; CX ring represents cardinal ligament insertion onto the anterior part of the cervical ring; PCF, pubocervical fascia; RVF, rectovaginal fascia; PB, perineal body; LP, levator plate; LMA, conjoint longitudinal muscle of the anus; EAS, external anal sphincter; PRM, puborectalis muscle; PCM, pubococcygeus muscle; R, rectum; UT, uterus; B, bladder; PS, pubic symphysis; S, sacrum.