Diagnosis and Tests
Diagnosis for Pelvic Floor Dysfunction
Before proceeding toward an accurate diagnosis, it is crucial to establish a patient’s history. This is done during the appointment with a doctor. The patient must be as truthful as possible during the process. The nurse or doctor may ask the following questions:
- Occurrence of urinary tract infections.
- Incidences of erectile dysfunction.
- Number of pregnancies if the patient is female.
- Any previous surgeries involving the lower body, abdominal surgeries etc.
- Issues regarding incontinence.
- History of painful intercourse.
- Any underlying diseases
The tests conducted to diagnose the condition can be carried out through imaging or physical examination like intrarectal and vaginal exams. However, if the patient does not want a physical exam, they can opt for any of the three procedures listed below:
- A defecating proctogram where the patient is given a thick enema visible on an X-Ray. The patient is required to push the enema out, which helps in imaging pelvic muscle control. The test is minimally invasive and does not cause any pain. The results are then analyzed to determine the extent of muscle control.
- A procedure called a POP Q exam is carried out for female patients to determine the extent of vaginal prolapse. The exam is manual and requires a speculum to be inserted to hold the vaginal walls open. A doctor then uses a system that involves mapping the vaginal cavity to determine the extent of the prolapse.
- Using surface electrodes, doctors can gauge the tonal quality of the pelvic floor muscles. The patient is made to go through a series of exercises. The electrical impulses generated by the muscles contracting and relaxing are recorded by the electrodes, helping establish an accurate diagnosis. This test is non-invasive.
- Anorectal manometry is a minimally invasive procedure that establishes the strength of the anal sphincter and the surrounding muscles. This test is minimally invasive and is not painful.
- A uroflow test measures how well the patient can empty their bladder. This test establishes the strength of the urinary sphincter and the surrounding muscles.