Chapter 4: Evaluation of Incontinence and Pelvic Floor
By Associate Professor Suvit Bunyavejchevin, Thailand and Associate Professor Marie Carmela Lapitan, Philippines
The foundation for the evaluation of incontinence and the pelvic floor lies on taking a proper history and on conducting a comprehensive physical examination. The goals of the initial evaluation are to identify the nature of the incontinence, the degree to which it interferes with the lifestyle and activities, the objective demonstration of incontinence, pelvic floor dysfunction and/or pelvic organ prolapse, and the identification of neurologic, gynecologic and other medical conditions that predisposes to incontinence and pelvic floor dysfunction.
Clinicians must be prepared to elicit a complete history directly from the patient, which should include questions investigating the urologic, obstetric, gynecologic, neurologic and other medical aspects of the patient’s condition. The physical examination of patients with incontinence and pelvic floor disorders should include a general assessment, a demonstration of the leakage through provocative stress test, a neurological examination, a gynecologic examination wherein prolapse may be graded as necessary, and an assessment of the pelvic floor muscle strength.
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