Pelvic floor disorders: evacuation, leakage and prolapse

Name the main difficulty

The pelvic floor contributes to support, continence and evacuation. Problems can present as prolonged straining, incomplete emptying, leakage, urgency or tissue protruding during bowel movements. Overlap does not mean that everyone has the same mechanism.

Tests answer different questions

Manometry assesses pressures, coordination and sensation. Balloon expulsion assesses evacuation under test conditions. Defecography can show movement and structural changes during emptying. Selection follows history and examination.

Prepare for the visit

Record stool consistency, straining, leakage and any need for manual assistance. Include childbirth, surgical and treatment history. Ask which problem the proposed plan addresses and how improvement will be measured.

Questions for your appointment

• Is coordination, structural support or both involved?
• What will each test add?
• How will progress be measured in daily life?

Further reading

• NIDDK — Diagnosis of constipation
• Comparison of anorectal manometry, balloon expulsion and defecography

Related guides

• Dyssynergic defecation
• Balloon expulsion test: what the result can and cannot show
• Fecal incontinence