Vaginal examinations are a very useful way of specifically assessing the pelvic floor and/or diagnosing pelvic conditions. This may be performed as an external visual assessment or may include an internal assessment component depending on your presentation/concerns and preferences.
Prior to an assessment, we will discuss what we recommend to be assessed as well as provide alternate options based on your preference. After this, we will ask for your consent to perform an internal assessment.
Externally, we may assess:
- Vulval skin condition – to check for any inflammation, discolouration, muscle atrophy, scarring or guarding.
- Pelvic floor contraction/relaxation – we can look at both voluntary contraction/relaxation as well as your ability to hold whilst you perform a cough to check for your control.
- Bearing down (valsalva) – We ask you to bear down like you’re pushing out a poo. This shows us how much distensibility/stretch can occur with downward pressure. We take some measurements at the entrance of the vagina and perineum.
Internally, if you are comfortable, we may assess:
- Tone – using a single finger to palpate (feel) muscle tension, tender points or pain/muscle spasm.
- Strength – this may be done using one or two fingers depending on your presentation. We will ask you to contract and relax your pelvic floor. We may ask you to do a number of repetitions of this to further assess your muscle endurance and coordination.
- Prolapse – this is assessed using a tongue depressor (not speculum). We will visualise or potentially palpate using a single finger to determine any pelvic organ laxity at rest or on bearing down.
During pregnancy, we can safely perform various measures to assess:
- Risk of perineal tears – potentially due to a short perineal body or poor distensibility of the perineum and/or pelvic floor
- Risk of obstructed/prolonged second stage of labour – potentially due to high pelvic muscle tone, difficulty to relax the pelvic floor during pushing
Vaginal assessments should not be painful. If it is, we stop.
Your consent will be asked repeatedly throughout the assessment. We want you to feel comfortable and informed at every step of the way. So if you do have any questions on what to expect, or if you are wanting to book in for an assessment click here or call the clinic 0400 573 457.