How is pelvic floor dysfunction diagnosed?
The doctor will begin your exam by asking about your symptoms and taking a careful history. Questions he or she may ask may include the following:
- Do you have a history of urinary tract infections?
- Have you given birth to a child?
- Do you have interstitial cystitis (a long-term inflammation of the bladder wall) or irritable bowel syndrome (a disorder of the lower intestinal tract)?
- Do you have pain with intercourse?
Next, the doctor will do a physical examination to evaluate your ability to control your pelvic floor muscles. Using his or her hands, the doctor will check for spasms, knots, or weakness in these muscles. The doctor may also conduct an intrarectal (inside the rectum) or vaginal examination.
You may also have these tests:
- The physician may test your pelvic muscle control by placing surface electrodes (self-adhesive pads) on the perineum (the area between the vagina and rectum in women, and between the testicles and rectum in men) or sacrum (the triangular bone at the base of your spine).
- An anorectal manometry (a test that measures how well the rectum and anal sphincter are working) may also be performed to test the pressures and muscle strength and coordination.
- Another test your physician may do is called a defecating proctogram. For this test, you will be given an enema of a thick liquid that can be detected with an X-ray. The physician will use a special video X-ray to record the movement of your muscles as you attempt to push the liquid out of the rectum.
- Some physicians may also perform a uroflow test as you try to empty your bladder. If the flow of urine is weak or you have to stop and start as you urinate, it can suggest pelvic floor dysfunction. This test may be ordered when you complain of a urinary issue.