Do I Need to Undergo an Internal Exam?
PLEASE NOTE: following information and associated clinical care relates to female patients only. We are not offering pelvic health care to male patients at this time.
Every day, every moment, every movement, without you having to even think about it, your pelvic floor muscles do their job in assisting bladder function, bowel function and sexual function. Your pelvic floor muscles also contribute to your core strength and stability, allowing your low back to function without difficulty or pain. Because we don’t have to pay attention to these muscles if they’re working well, we often take them for granted and never think to assess and ensure their proper function and good health through our own daily activities.
A commonly known term in pelvic health is The Kegel. Possibly more familiar with women than men, it originates with Dr. Arnold Kegel who as a gynecologist in the 1940s, utilized an internal vaginal examination to evaluate pelvic muscle tone and strength in his female patients. This method was also effective in monitoring each patient’s performance of the strengthening maneuvers he prescribed them. Now part of conventional pelvic health lexicon, Kegels are unfortunately often incorrectly prescribed for conditions they are not indicated for, and also quite commonly, performed incorrectly. Part of the problem is that many urologists, gynecologists, nurses and physiotherapists don’t bother to include the internal exam in assessing the patient’s problem nor monitoring their performance of these exercises. Resultingly, these practitioners share a poor success rate in treating pelvic floor muscle dysfunction and the conditions they lead to. This causes obvious frustration for any female patients attempting to utilize Kegels therapeutically or preventatively.
In European countries, the gold standard continues to be the internal examination of the pelvic floor has been the gold standard by which treatment of the pelvic floor has been carried out for more than 30 years. In Canada, we are a more puritanical society, and it seems “weird” or “strange” to assess the pelvic floor by completing an internal exam of the vagina or rectum. However, when the pelvic floor muscles are assessed this way, the research has shown that the treatments carried out by a physiotherapist for pelvic floor problems are highly successful, and should be the first line of defense (before surgery or any other medical intervention) for both pelvic pain and incontinence.
Your Pelvic Floor Health Physiotherapist
Roja, your pelvic floor physiotherapist who carries out this work is a highly trained, sensitive professional who will discuss these issues with you thoroughly before carrying out the treatment. She is properly trained and equipped to perform this sensitive and delicate component of your care. The exam table will be covered with clean linens and exam paper. Your therapist will also wear latex-free nitrile examination gloves and use a safe, non-toxic, unscented, hypoallergenic lubricant to make the procedure as comfortable as possible. Internal palpation is an integral part of treating the pelvic floor and is the gold standard in pelvic floor care. Accept nothing less.