Pelvic Floor Assessment Form

History of presenting illness.

Pelvic floor assessment form.

Pelvic pain assessment form. Yes no maybe. Yes no n a. I understand that to evaluate my condition it may be necessary for my physical therapist to perform an internal pelvic floor exam to assess strength tissue mobility and muscle length.

Similar to the pfiq 7 it is a health related quality of life questionnaire for women with pelvic floor conditions to fill out. Assessment form audit clinical effectiveness continence pelvic floor dysfunction. The pfdi 20 is comprised of 3 scales which include the urinary distress inventory 6 udi 6 pelvic organ prolapse distress. Achieving and maintaining pelvic floor health is essential to lifelong sexual enjoyment by minimizing or preventing injury and increasing arousal and sexual intensity.

Digital assessment is essential to evaluating pfm strength and also enables the np to detect the presence of a prolapse a mass or weakened pfms or the presence of any conditions related to. Patient describes vaginal bulge. Digital assessment of the pelvic floor muscles evaluation of pfm strength provides a quantitative assessment of the voluntary contraction of these muscles. Pelvic floor pathway patient assessment form updated june 2014 page 3 of 4 other dyspareunia.

Assessing the pelvic floor before assessing a patient s pelvic floor nurses need to conduct a comprehensive continence assessment that includes a full medical surgical and obstetric his tory medication weight presenting symptoms and lifestyle factors national. The pelvic floor distress inventory questionnaire 20 pfdi 20 is the short form version of the pelvic floor distress inventory pfdi. Male pelvic floor therapy refers to a number of therapeutic assessment and treatment techniques intended to decrease pain and increase your control of your pelvic floor muscles. Search for similar articles you may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Initial history and physical examination date this assessment form is intended to assist the clinician with the initial patient assessment and is not meant to be a diagnostic tool. Assessment of the pelvic floor i understand that my physician has referred me to physical therapy for pelvic floor dysfunction. Female pelvic floor and the causes and con sequences of pelvic floor weakness.