I realize that a lot of ladies may feel apprehensive about a pelvic floor exam so I wanted to quickly share with you the ways that we go about this. There are a few ways in which we can assess the pelvic floor and it all depends on what you are most comfortable with.
Method 1: External palpation
The first test is the external palpation of the pelvic floor muscles. This can be done in standing or with you lying on your back and your knees bent. My hands will be placed just on the inside of your sit bone. Here we are feeling the muscle movement from the outside of the body, the same way we would feel your bicep.
Method 2: Imaging with real-time ultrasound
Next, we would use our real-time ultrasound (RTUS) to check the pelvic floor. We get an image of the bladder and then the movement of the bladder following different cues gives us a good picture as to how the pelvic floor is working. I love my real-time ultrasound because it allows me the opportunity to show ladies how their pelvic floor is working.
It has been so wonderful having the RTUS as a method of assessment and treatment as it is the most non-invasive method of seeing what is going on with the pelvic floor muscles. People also find it easier to be able to connect to their pelvic floor when they can see what is happening. There is always a little light bulb moment when they get the connection for the first time.
Method 3: Internal exam
And lastly, we do the internal pelvic floor exam. This is done by inserting one finger into the vagina to test the tone and function of the pelvic floor muscles. Please note that we don’t always do this exam on the first session and you can consent or decline to this exam at any point.
A well rounded picture
By doing all 3 tests we are able to get a really well-rounded understanding of the condition of the pelvic floor muscles and what they are needing. We always look at function on both the left and right sides of the pelvic bowl. And most importantly we believe that the pelvic floor should be able to relax just as well as it can contract.
Please contact me if you have any questions about the pelvic floor muscle exam; I would love to talk more about it with you so that you can feel comfortable.