Intra-rater reliability of vaginal palpation, vaginal manometry and dynamometry in assessing pelvic floor muscle contraction and discomfort between these methods

Objectives

To assess the intra-rater reliability and comfort level of three methods of evaluating the pelvic floor muscles: vaginal palpation, vaginal manometry and vaginal dynamometry in women with or without reports of urinary incontinence.

Methods

Test-retest reliability study with assessment and reassessment carried out by vaginal palpation, vaginal manometry and dynamometry, in random order and by the same examiner, with an interval of seven days. The visual numerical scale was used to check the level of discomfort of the assessment methods. The Weighted Kappa Coefficient was used to analyze the reliability of vaginal palpation, while the Intraclass Correlation Coefficient (ICC) was used for vaginal manometry and dynamometry. To establish the difference between the level of discomfort of the methods, the Friedman and Wilcoxon tests were used.

Results

The results showed almost perfect intra-rater reliability for vaginal palpation (k = 0.8443; p < 0.001), excellent reliability for dynamometry (ICC3.3 = 0.789; p < 0.001) and high reliability for manometry (ICC3. 3 = 0.967; p < 0.001). Furthermore, a significant difference was observed in the level of discomfort between vaginal palpation and vaginal manometry (p = 0.001).

Conclusions

The three methods of assessing pelvic floor muscles demonstrated an excellent intra-rater reliability. However, vaginal palpation was considered the most comfortable.