Common Tests for the Pelvic Floor

Pelvic floor disorders, including obstructed defecation, fecal incontinence, and rectal prolapse, affect a significant portion of the population and are increasing in prevalence as the population ages. An evaluation of pelvic floor anatomy and function is warranted in patients who fail to respond to conservative therapy. Advances in anal manometry and its interpretation can provide detailed answers on anal sphincter and puborectalis motor function, as well as sensation of the rectum. Neurophysiologic testing can allow a more detailed evaluation of neurologic injury and global motor function of the pelvic floor as a unit. Anal ultrasound remains the gold standard in structural imaging of the anal sphincters. The multiple modes of dynamic imaging, including fluoroscopic defecography, MR defecography, dynamic ultrasound, and echodefecography, provide both structural and functional assessment of pelvic floor patients. These common pelvic floor tests provide the surgeon with better understanding of the pathophysiology of pelvic floor disease, leading to more effective treatment of symptoms.