Re: ctal exams during WWE
From: rose (anonymous@obgyn.net)
Fri, 21 May 1999 10:25:58 -0500 (CDT)
Since my doctor has never done part of my exam in the standing postion,
exactly what step by step process should they do so I can use this
information at my next checkup.
--
Rose
At Fri, 21 May 1999, anonymous@obgyn.net wrote:
>
>At Wed, 19 May 1999, Sheila wrote:
>>
>>I am a FP physician. I do a great deal of work in women's health. I
>>was taught to perform a rectal exam with each WWE. In practice, I
>>perform a rectal exam (RE) on everyone, other than initial paps and
>>those who have never been sexually active.
>>It seems to be a big controversy as to who should have rectals. Everyone
>>agrees that anyone over 50 should get one each year. Some agree that
>>anyone over 40 should get one each year. But what about those under 40
>>who are otherwise asymptomatic?
>>Are there any guidelines on this from the American College of
>>Obstetricians and Gynecologists?
>A rectal exam has another benefit, maybe one you never considered. I
>think women should be checked for pelvic floor muscle strength. Most
>women who are incontinent (urine or fecal), do not inform the doctor of
>this fact. They are too embarrassed. Also since most women do not even
>know what prolapse actually is, they are not aware that pelvic floor
>weakness could be a sign of organ prolapse. Pelvic floor muscle
>weakness contributes to organ prolapse. Not enough is being done to
>inform women of the importance of keeping muscle strength. Nor are they
>told the proper way to keep ALL of the muscles of the pelvic floor
>strong.
>Women are told to do kegals, but not told about prolapse. Prolapse is
>NOT uncommon, and it doesn't just happen to OLDER women. If women were
>told about prolase, maybe by changing their lifestyle they could prevent
>the extend of prolapse damage. Women should be told why it is dangerous
>for them to left heavy loads or move heavy furniture. They should be
>told cronic coughing and constipation contributes to prolapse. These
>things can be remedied.
>Women should be checked at each annual exam in a standing position.
>Their pelvic floor muscle strength should be checked too. Maybe a
>biofeedback unit should be a basic piece of equipment.
![[ Women's Health Forum ]](http://www.obgyn.net/images_women/wh-forum.gif)