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Physiologic evaluation of the pelvic floor
1Department of Obstetrics and Gynecology, Texas A&M University College of Medicine, Scott & White Clinic, Temple, USA.
Obstetrics and Gynecology Clinics of North America
|January 28, 1999
Summary
Physiologic tests evaluate pelvic floor dysfunction, aiding diagnosis of urinary and bowel issues. These validated methods, including urodynamics and manometry, are crucial when history and physical exams are insufficient.
Area of Science:
- Urology
- Gastroenterology
- Gynecology
- Neurology
Background:
- Pelvic floor dysfunction affects urinary and bowel function.
- Accurate diagnosis relies on understanding the underlying pathophysiology.
- Physiologic testing offers objective measures for complex cases.
Purpose of the Study:
- To review the value, techniques, rationale, and limitations of common pelvic floor physiologic tests.
- To highlight the role of these tests in diagnosing lower urinary tract and anorectal disorders.
- To emphasize the importance of test validation and reliability.
Main Methods:
- Urodynamics for lower urinary tract evaluation (bladder filling/emptying).
- Neurophysiologic tests (EMG, nerve conduction) for neuromuscular integrity of sphincters and pelvic floor.
- Anorectal manometry for rectal pressure, compliance, and reflexes in incontinence/constipation.
- Colonic transit studies for functional constipation assessment.
Main Results:
- Urodynamics assesses bladder function.
- Neurophysiologic tests evaluate sphincter integrity.
- Anorectal manometry aids in diagnosing incontinence and constipation.
- Colonic transit studies identify functional constipation.
Conclusions:
- Physiologic tests are valuable for evaluating pelvic floor dysfunction.
- Validated and reliable tests are essential for accurate diagnosis.
- History and physical examination typically identify patients needing further physiologic evaluation.