Diagnostic testing

Anorectal ultrasonography may also be called transperineal ultrasound or pelvic floor ultrasound. A small ultrasound transducer is placed over the skin between the vagina and anus. The muscles of the anal canal can be comprehensively evaluated with the use of anorectal ultrasonography. This type of ultrasound evaluation is often used in the evaluation of women with fecal incontinence.

Sometimes the muscles of the anus (anal sphincters) become damaged due to child birth, trauma, and/or prior surgery. The nerves controlling these structures may also be damaged. A careful history, physical examination, and ultrasound often lead to a comprehensive understanding of the problem and development of an effective treatment program.

Pelvic floor ultrasound (PFUS) provides unique visualization of pelvic muscles and related structures, which can be useful for the evaluation of women with pelvic organ prolapse, fecal incontinence, urinary symptoms, symptoms related to childbirth, and general gynecologic disorders such as abnormal bleeding, cysts, fibroids to name a few.

Anorectal manometry is a medical test used to measure pressures in the anus and rectum and to assess their function. The test is performed by inserting a catheter, that contains a probe embedded with pressure sensors, through the anus and into the rectum.

Defecography is a special MRI test used to evaluate pelvic floor and bowel function. The test is routinely performed in the radiology department. Contrast material (gel) is placed into the rectum and vagina. MRI is then performed during squeezing and relaxation of the pelvic floor and during evacuation of the gel.

Cystoscopy is a test that allows direct visualization of the bladder and urethra. A thin, lighted instrument called a cystoscope is slowly inserted into the urethra and advanced into the bladder. Tissue biopsies can be obtained by inserting tiny surgical instruments through the cystoscope. A cystoscopy is performed in situations where laboratory tests and/or imaging tests such as ultrasound and X-rays do not provide the necessary information to render a diagnosis.

Urodynamics comprise a series of tests of the lower urinary tract. They are commonly performed during the evaluation of urinary incontinence, but can be useful for evaluating other conditions as well. A small tube is placed into your urethra and advanced into your bladder. The tube allows the bladder to be filled with a sterile solution and pressures in the bladder and urethra to be recorded. An additional tube is placed in either the vagina or rectum for additional pressure measurements. The test takes about 15 minutes to complete.