This is my second post, and I hope I'm not way over my head. Sorry for poor english and medical lingo. Anyway.

27-year old nulliparous woman.
Complains about problems with pelvic floor. The symptoms are poorly localized and the patient can't define very well what's wrong.
The problem has started 5-years ago. The patient was drunk, and her bladder was painfully full, but instead of going to bathroom she was pressured into sex. She tells that she realised during the intercourse that something was wrong. Afterwards wasn't able to void for an hour or two even though bladder was painfully full.

After this incident patient has felt that something was wrong, loose and broken. Needs to keep pelvic floor muscles tense all the time, because fears that something is wrong. Patient feels that bladder hasn't properly emptied since the episode, and she needs to go to bathroom all the time, but doesn't get proper relief, though some urine always comes.

After the incident she went to a doctor. After ultrasonography the doctor concluded that nothing was wrong. Patient feels that Doctor was so repulsed by her problem that didn't want to properly examine.

The patient has a history of mental problems since the age of 15. Undefined Schizophrenia is doubted. She's using ziprasidone since a week a go, when she used quetiapine. The symptons have recently gone worse. She's constantly anxious and talks about killing her self because of this pelvic floor problem.

Now what do you do? The patient seems to be clearly somatizing, but isn't willing to get any psychiatric help before she gets properly examined. No motivation for psychiatric treatment.