Q: In serious cases, you may be able to feel your bladder descend into your vagina. When you sit down, it may feel like you are sitting on a ball or an egg; this feeling may disappear when you stand up or lie down. This is the most obvious symptom of a cystocele, and you should see your primary care physician or gynecologist as soon as possible. This feeling is generally considered a sign of a severe prolapsed bladder. If you have any pain, pressure, or discomfort in your lower abdomen, pelvic area, or vagina, you should see a doctor. Any number of conditions, including a prolapsed bladder, could cause those symptoms.  If you have a cystocele, this pain, pressure, or discomfort may increase when you cough, sneeze, exert yourself or otherwise place pressure on the muscles of your pelvic floor. If this is the case, be sure you mention it to your doctor. If you have a prolapsed bladder, you may also feel like something is falling out of your vagina. If you tend to leak urine when you cough, sneeze, laugh, or exert yourself, you have what’s known as “stress incontinence.” Women who have given birth are particularly susceptible, and a prolapsed bladder can be a major cause. See your doctor to resolve the issue.  Notice as well if you've experienced any changes when you urinate, including difficulty initiating a stream of urine, incomplete emptying of the bladder (also known as urinary retention), and increased urinary frequency and urgency. Note if you've had frequent bladder infections, or urinary tract infections (UTIs). "Frequent" is defined as having more than one UTI in a six-month period. Women with cystoceles often wind up with frequent bladder infections, so it's worth paying attention to the frequency of your UTIs. Pain during sex is called “dyspareunia” and can be triggered by a number of physical conditions, including a prolapsed bladder. If you are dealing with dyspareunia, you should see your primary care physician or gynecologist as soon as possible. If pain during intercourse is a new development for you, and you’ve recently delivered a baby vaginally, then a prolapsed bladder is a particularly likely cause. Don’t delay seeing your doctor. Some women with cystoceles also experience pain, pressure, or discomfort in the lower back area. Back pain is a very general symptom that could mean many things – or nothing serious at all – but it makes sense to schedule an appointment with your doctor. This is especially the case if you are experiencing any of the other symptoms. If your case is a mild one, you may not notice any the above symptoms. Some cystoceles are first discovered during routine gynecological examinations.  However, if you exhibit or experience any of the symptoms described above, you should consult your primary care physician (PCP) or gynecologist. If you do not experience symptoms there is often no need for treatment.
A: Feel for a bulge of tissue in your vagina. Note any pelvic pain or discomfort. Consider any urinary symptoms. Take pain during sexual intercourse seriously. Monitor your back pain. Know that some women have no symptoms at all.

Q: Optimal tree growth can be promoted by choosing 3-5 branches located 18–36 inches (46–91 cm) from the ground. These will serve as your primary fruit-producing branches.  It’s best to choose branches that are growing outwards away from the trunk, rather than straight up, as vertically-growing branches are more prone to snapping off if they produce a lot of heavy fruit. Think of a clock, and look to keep branches growing outwards at about a 2:00 or 10:00 angle.  All of the scaffold branches should be evenly spaced around the trunk of the tree so that the tree’s structure is well-balanced.  Mark these scaffold branches with a piece of brightly-colored ribbon or string, so you won’t accidentally trim them later. Keeping these intact will help prevent over-pruning and ensure your apricot tree’s overall structure is sound. Use a shears to clip thinner, new branches, or use a pruning saw to cut thicker boughs. Look for the collar at the base of the branch. This is a thicker, ridged area of bark that connects the branch to the trunk. Cut the branch just outside the collar, as this region promotes formation of new tissue and cutting it can cause damage and introduce decay. There should be plenty of space surrounding your tree’s primary branches. This helps promote adequate air circulation and lets sunlight reach all the way down through the tree to apricots on the lower branches. Thinner branches towards the top of the tree can be left a little closer together, whereas the thickest branches towards the bottom need the most space. Aim to remove about ⅓ of branches overall. Apricot trees tend to grow quickly and therefore need more pruning than some other fruit trees. You should be left with sparse but evenly-spaced branches throughout the height of your tree. Cut more branches off of young trees, and less off of older ones. During an apricot tree’s first three years, prune aggressively to aim for growth rather than fruit production.
A:
Choose a few healthy scaffold branches that you want to keep. Cut most of the remaining branches about 0.25 inches (0.64 cm) above where they connect to the trunk. Prune branches located within 8–10 inches (20–25 cm) of your scaffold branches. Thin out the entire tree by removing extra branches.