Pelvic Floor Assessment
- What to expect
Our initial consultation involves 4 basic stages
1. A discussion about your symptoms, concerns, past history and/or treatment, general health and goals
2. Education about the anatomy and function of the different aspects of the pelvis
3. A physical assessment to determine the root cause of your symptoms which may include any or all of the following:
Assessment of your spine, pelvic and hip mobility and alignment
Functional tests to assess the coordination, strength and endurance of the muscle systems around the back, pelvis and hips
Abdominal muscle status and function
Assessment of the internal aspects of the pelvis via digital vaginal examination or real-time ultrasound looking at
The 2 layers and sides of the pelvic floor muscles for damage, pain, muscle bulk, tone, coordination, strength and endurance
Position of the bladder, urethra, uterus and bowel to determine if there is a pelvic organ prolapse
Objective assessment of the pelvic floor muscles using the Neurotrac (EMG) or Peritron (pressure biofeedback) units
4. Discussion of the findings from the assessment and formulation of a plan tailored to your own personal goals. This will include treatment options, prognosis and expected time frame to achieve a result. All treatment is tailored around your specific goals to enable you to achieve them in the most efficient time frame possible.
Is an internal assessment necessary?
For internal pelvic problems (pain, dysfunction, prolapse, incontinence etc), the simple answer to this question is yes, for women and no, for men (unless pelvic pain is the concern, then an internal may be appropriate for full assessment of the muscle tone and ability to relax).
For women, the detail gained from an internal examination in comparison to a real-time ultrasound assessment is significantly different. This effects how accurate our diagnosis is and how efficient our treatment will be. However, we are very aware that an internal may be inappropriate (e.g. teenagers) or unwanted and fully respect this. In these cases we do use the ultrasound to gain some insight into the pelvic muscles and organs and use this information to guide our treatment.
For men, the opposite is true (due to the difference in anatomy). The ultrasound probe is placed on the perineum (the area between the testicles and anus) which enables us to visualise the pelvic floor muscles in much greater detail than the information gained via an internal examination. However, if pain is the primary concern an internal assessment will give us much more information about the muscle tone and function. As for women, if this assessment is appropriate, then it will be fully discussed with you first so that you understand the process and can either consent or decline.