Pelvic floor disorders may first be suspected by yourself, your primary doctor, or gynecologist. Consulting with a urogynecologist will be helpful in obtaining an accurate diagnosis and understanding your treatment options. Besides a complete history and physical, one or more of these diagnostic studies may be recommended:
- Bladder Diary
This is a 24-hour record of your intake, output, pad use and leakage episodes. Careful records help to determine symptom severity, leakage "triggers," and type of incontinence. This is something you can do even in preparing to see the urogynecologist.
A narrow telescope (cystoscope) is inserted into the urethra and glided up into the bladder allowing visualization and evaluation of the inside of the urethra and bladder. This is generally performed using a local anesthetic gel in the urogynecologist's office or operating room as an outpatient.
- Urodynamic Testing
This test involves inserting a very narrow catheter through the urethra into the bladder and another into the vagina or rectum to measure pressures inside the bladder, urethra and abdomen while filling the bladder slowly with sterile water. The patient is asked to cough and strain throughout the bladder filling. This assesses how well the bladder and urethra are performing their functions. This is generally performed using a local anesthetic gel in the urogynecologist's office.
- Anal Manometry
In this test, a special balloon is inserted into the rectum to test the muscles that control the bowels. Anorectal manometry is a test performed to evaluate patients with constipation or fecal
incontinence. This test measures the pressures of the anal sphincter muscles, the sensation in the
rectum, and the neural reflexes that are needed for normal bowel movements.
- Ultrasound of the Anal Sphincter
A small ultrasound probe is inserted into the anal canal and rectum to assess structure and integrity of the anal sphincter. This test is generally performed in the radiology department on an outpatient basis.
- Defecography (or Defecogram)
This is a special x-ray study that shows the rectum and anal canal during a bowel movement. It allows the doctor to visualize what occurs as you empty your rectum. This test is generally performed in the radiology department on an outpatient basis.