Common Tests for the Pelvic Floor

Pelvic floor disorders affect a significant portion of the population, and their prevalence increases with age. Colorectal surgeons will undoubtedly be called upon to evaluate and treat this complex patient population. A thorough history and physical examination are of paramount importance. Often patients do not report their symptoms unless directly asked due to embarrassment. There are several validated standardized questionnaires that are useful to quantify patient’s symptoms and monitor the effects of treatment. For the group of patients whose symptoms are not responsive to conservative or noninvasive therapy, a more detailed evaluation of pelvic floor structure and function is necessary. There are multiple modalities available to physicians to accomplish this goal. Studies that assess anatomic structure include anal ultrasound and MRI. Functional evaluation can be assessed with anal manometry, neurophysiologic testing, and the various methods of gastrointestinal transit testing. Both MRI and standard cinedefecography provide both structural and functional assessment. The use of these tools in the evaluation of this patient population can greatly augment the physicians’ understanding of the pathophysiology responsible for functional complaints and lead to more effective treatment regimens.