“Simulated operation” relieves pain and urge by supporting USL. Left: 3D view of the PUL and USL attachments to the pelvic brim. A gently inserted speculum mechanically supports lax USLs and pelvic visceral nerve plexuses (VP). The test, if successful, decreases afferent pain and urge impulses; the patient reports lessening pain in multiple sites, for example, “B,” “R,” and “M” (right image). Co-occurring urge is also often relieved by speculum support of urothelial stretch receptors “N.” Right: 3D view of pelvic organs. The VP comprises sympathetic plexus (SP) and parasympathetic plexus (PS). The yellow lines represent visceral nerves to and from the end organs. M, muscles; V, vagina/vulva; B, bladder; R, rectum; G, force of gravity acting on “VPs” (left figure); PCM, pubococcygeus muscle; PUL, pubourethral ligament; ATFP, arcus tendineus fascia pelvis; USL, uterosacral ligament; CL, cardinal ligament; LP, levator plate; LMA, conjoint longitudinal muscle of the anus; L, USL laxity.