Visual inspection and digital tests are easy and reliable methods by which insight can be gained into the multi-muscular activity and coordination of the pelvic floor and lower abdominal muscles in continent and incontinent women.

No abstract

Conservative therapies such as pelvic floor re-education and colonic irrigation can improve anorectal function. SNS might be an effective solution in selected patients. However, methodologically qualitative studies are limited and randomized controlled trials are needed to draw evidence-based conclusions.

Contractions of the superficial and deep pelvic floor muscles can be recorded by intravaginal or perineal electrodes. A consistent contraction sequence can be found in continent women but it is lacking in incontinent women. This might be a possible explanation for incontinence. Including differentiated muscle contraction exercises in pelvic floor muscle exercise programs may further optimize treatment outcomes.

Anorectal dysfunction is a frequent problem after management of rectal cancer with an impact on the well-being of patients.

Perineal pad tests are simple, noninvasive functional tests which have been recommended for the evaluation of patients with urinary incontinence. Most are based on the one-hour pad test introduced by Sutherst and co-workers and standardized by the International Continence Society. The major problem with the one-hour pad test is its lack of sensitivity. Therefore a stringent test procedure was developed, whereby the limit of patient tolerance was reached. Mean end volumes of 568 ml (648 ml) immediately after the test (retest) confirmed that the patients had been examined with full bladders. Yet one in three of the incontinent patients remained dry during formal assessment. The use of the one-hour perineal pad test for clinical or research purposes should be seriously questioned.

No abstract