The binary cortico/peripheral control systems of bladder and bowel are virtually identical. Afferent impulses from stretch receptors “N” in the bladder and bowel proceed to the brain which interprets them as “fullness.” By reflexly stretching bladder and bowel bidirectionally (large arrows), the muscles tension the underlying supports of the stretch receptors “N” of the bladder or rectum to support their contents; this prevents them from firing off emptying impulses prematurely, thereby controlling inappropriate activation of the micturition and defecation reflexes, sensed by the cortex as “urge to go.” If convenient to empty, the closure reflex shuts down, and the emptying reflexes (micturition and defecation) are activated. The posterior walls of the urethra and anorectum are actively pulled open (broken lines) by LP/LMA immediately prior to evacuation. This external opening exponentially decreases resistance to flow, thereby facilitating evacuation. Dysfunction. Anatomical damage to any part of the system may interfere with the binary control of all the above functions. Cortex: facilitatory or inhibitory centers; nerves: afferent or efferent (for example, MS); peripheral: ligament or muscle damage; pressure or inflammation on stretch receptors “N” by cancer, cervical fibroid, bladder or rectal prolapse. Surgical cure. “Repair the structure (ligaments, vagina) and you will restore the function” (1). The diagnostic algorithm (as shown in Fig. 2) indicates which ligaments or fascias may be damaged. USL (as shown in Fig. 5) and PUL (as shown in Fig. 6) can be tested for symptom improvement by mechanical support, thereby predicting a high possibility of cure. PUL, pubourethral ligament; USL, uterosacral ligament; CL, cardinal ligament; N, bladder base and anorectal stretch receptors; LP, levator plate; LMA, conjoint longitudinal muscle of the anus; EAS, external anal sphincter; PCM, pubococcygeus muscle.