A guide for your face-to-face Pelvic Floor appointment

Depending on your symptoms you will be seen in one of the following clinics:

• Pelvic Floor Specialist Nurse Clinic
• Joint clinic with the Pelvic Floor Specialist Nurse and Specialist Physiotherapist
• Joint clinic with the Pelvic Floor Specialist Nurse and a Colorectal Consultant Surgeon.

If you are unable to attend or would like to change your appointment, please ring (01305) 255604 as soon as possible.

What will happen at the appointment?

• You may be examined; this may entail a digital rectal examination and/or a vaginal examination to assess your pelvic floor.

• You may be be given an individualised exercise plan to help strengthen or relax the pelvic floor, depending on the findings of the examination.

• You may be prescribed medication to help with your symptoms.

• An onward referral may be required for rectal irrigation or the bladder and bowel service for support in the community.
• If indicated an onward referral to other departments within the hospital ie. Urology, Gynaecology or Gastroenterology will be actioned.

• Additional tests may be needed before a treatment plan is agreed.

What tests may I need?

Different tests give us different information about how your bowel is functioning.  The most common tests requested from these clinics are:

• Flexible Sigmoidoscopy
• Blood tests
• Stool tests
• Defecating proctogram
• Anorectal physiology
• Endoanal ultrasound
• Transit study

If you have any high-risk symptoms then you will be referred to another specialist clinic for further assessment and investigation.

Descriptions of these different tests are listed in the glossary at the back of this booklet.  The specialist will explain the test to you and answer any questions that you may have.  You will be sent more information about the test including any risks and benefits in the post.

If blood tests are needed, you will be given a blood test form.  We will ask you to make an appointment with the Nurse at your GP surgery and take the form with you.  If your GP does not provide this service, you can book a blood test appointment at Dorset County Hospital by calling 01305 254822 between 11:00am-1:00pm Monday to Friday. You can also have your blood test taken at Weymouth Community Hospital from 8.15am-2pm on a Monday and Wednesday.

What if I choose not to have the tests that are recommended?

You will have an opportunity to discuss this with the Colorectal Specialist at your appointment.  There may be alternatives that you are happy to have.

What happens after I have had my investigation or test?

Once the test/s have been carried out you may be listed on to the Monthly Disciplinary Team meeting (MDT). Once this has taken place you will be contacted by telephone, or an appointment will be made to discuss the outcome.  

Glossary of Terms

Anorectal physiology – These tests assess the strength and function of the anal sphincter muscles. The tests also look at the coordination of these muscles, and how much volume the rectum can hold. A catheter (small tube) is then placed into your rectum and a tool used to withdraw the catheter at a steady rate, measuring the strength of your muscles as the catheter is withdrawn. This will need to be repeated several times- sometimes with you relaxed and sometimes squeezing your anal muscles. A small balloon is then attached to the end of the catheter and placed into your rectum. Small bursts of air are pumped into the balloon. You will be asked to describe your sensations as this is done.

Defecating proctogram – a test using real time X-rays to examine your rectum (back passage) and the muscles that support your pelvic floor. It demonstrates what happens when you empty your bowels and why you may be having problems doing this.

Endoanal Ultrasound – An endo-anal ultrasound assesses the anatomy of the anal canal. The examination will be performed using an ultrasound scanner placed within the anal canal. A picture will be generated which will allow identification of the muscles in the anal canal – this will then be used to help determine the best treatment for you.

Faecal Immunochemical test or FIT test – This stool test checks for traces of blood that you would not be able to see.  This is a more sensitive test than the one used for bowel cancer screening and if positive, bowel investigations will be recommended. You will receive the test kit in the post for you to complete this at home. It only requires one sample of stool. Once you have collected the sample, please take it to your GP practice.

Flexible Sigmoidoscopy – a thin flexible telescope with a camera on the end is inserted into the bowel via the back passage.  The lower third part of the large bowel is examined.  You will be sent some laxative tablets with instructions to take the day before this test.

Stool tests – you may be asked to collect some stool (poo) for testing.  This might be to check for infection, blood or inflammation in your bowel.  You will be given a blue pot and a form for this which can be taken to your GP surgery.

Transit Study– This test shows how well food moves through the colon. The patient swallows capsules containing small markers which are visible on X-ray. 

About this leaflet:

Author: Nicola Davies, Pelvic Floor Specialist Nurse
Written: April 2023
Review date: April 2026
Edition: v1