A large part of physiotherapy assessment is examination. In Women's Health Physio this exam can include internal vaginal examination.
What does this involve? The physio will discuss what the exam is, why it is needed, and what it consists of and then ask for permission to perform the exam. If permission is granted then the exam is performed with the woman lying down on her back in a comfortable position and covered up with a towel. The exam will basically consist of the physio using one finger inserted in the vagina checking for pelvic floor dysfunction. Depending on what the practitioner is examining can vary on what the procedure is, however, the exam should be pain free or trying to figure out where the pain is coming from. The patient can, at any time, discontinue the examination even if the practitioner has not completed it.
If you attend a session, do you have to have an internal vaginal exam? No. Sometimes an exam is not needed. Other times the exam is necessary but the patient is uncomfortable with the internal nature and would not like to do this. Even though internal vaginal examination is the best way to assess certain issues, it is not the best if the patient does not consent or is extremely uncomfortable with the process. We have other methods of assessing which include real time ultrasound. This can be performed either by placing the ultrasound low on the belly over the bladder or on the vagina (transperineally).
Can any physiotherapist perform an internal vaginal examination? No. Only physiotherapists with advance and specific training in this area can perform internal vaginal examination.
In your session, please discuss your concerns about internal vaginal examination with your physiotherapist.