Common Tests for the Pelvic Floor

The American Society of Colon and Rectal Surgeons’ Clinical Practice Guidelines for the Management of Fecal Incontinence

“…Examining patients during a Valsalva maneuver or when straining on the commode may demonstrate a mucosal or full-thickness prolapse. 45 Digital examination may provide rough estimates of anal resting tone, squeeze pressure, muscle coordination (including the use of accessory gluteal muscles), and sphincter integrity. Furthermore, it is important to exclude the presence of a distal rectal mass, stricture, or fecal impaction, which would suggest other causes of incontinence.…”

“…Anorectal physiology (ARP) testing consists of a number of elements that measure the resting and squeeze pressures of the anal sphincter, determine the length of the high-pressure zone and the pressure profile of the anal canal, and assess anorectal sensation, rectal capacity, and rectal compliance. [45][46][47][48][49][50][51][52][53][54][55] Consensus statements have recommended standardizing definitions for various manometric variables to facilitate both clinical care and research. 53,54 A meta-analysis of 13 studies, including 2981 patients with FI and 1028 controls, indicated that the number of appropriately controlled studies evaluating anorectal manometry is small and that the risk of bias within the literature was high.…”