G_CS_29 Pelvic Floor Muscle Assessment
In order to improve patient care and reduce the risk of errors in practice, it is the remit of LCHS to provide a standard approach to the procedure of assessment of the pelvic floor muscles in both the female and male patient. This can be done by either vaginal examination or digital rectal examination in the female patient or by a digital rectal examination in the male patient.
Vaginal/ digital rectal examination to assess pelvic floor muscle tone is an integral part of a comprehensive continence assessment. However, it is a specialised skill and requires recognition that it is an invasive procedure on an intimate part of the body.
The NICE Guidance (2006) for the Management of Urinary Incontinence in Women specifies the importance of "routine digital assessment of the pelvic floor muscle contraction should be undertaken before the use of supervised pelvic floor muscle training for the treatment of Urinary Incontinence". As such this policy will provide a framework for the practitioner to undertake this procedure in the course of the continence assessment. It is recognised that there are various levels of skill required for this procedure and this policy will outline the boundaries and responsibilities of staff groups.
Similarly, in men, verification of the ability to contract the pelvic floor muscles is also fundamental to the initiation of pelvic floor muscle training. This function can be confirmed by digital rectal examination to ensure effective management of urinary storage or post-micturition symptoms and erectile dysfunction (Dorey, 2008).