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Is there agreement between the preference of examiner and women for unidigital and bidigital vaginal palpation? A qualitative study

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Abstract

Introduction and hypothesis

The International Continence Society recommends vaginal palpation as a method for assessing pelvic floor muscle (PFM) function. Our aim was to analyze the agreement between preferences of examiner and participants according to unidigital and bidigital vaginal palpation during PFM assessment. The second aim was to investigate qualitatively women’s perception of vaginal palpation.

Methods

Maximal voluntary contractions (MVCs) were requested during both types of vaginal palpation and were classified by the Modified Oxford Scale (MOS). Examiner and participants answered if they had preferences regarding vaginal palpation. Women answered qualitatively what they felt during the assessment. Cohen’s linear kappa (κ) evaluated the agreement after allocation of the women with a weaker and stronger MVC and qualitative analysis was performed by transcription considering age range (18–35; 36–59; ≥60 years).

Results

Agreement was almost zero for women with weaker and stronger MVC at unidigital (κ = 0.06 and κ = −0.12) and bidigital vaginal palpation (κ = 0.008 and κ = 0.005). Participants associated bidigital palpation with more perception and an easier way of contracting the PFMs. Women between 36 and 59 years associated unidigital palpation with a harder but comfortable way of contracting the PFMs. Subjects aged ≥60 years associated bidigital palpation with an uncomfortable, harder way of contracting PFM, with less space into the vagina.

Conclusions

Agreement between preferences was almost zero neither between women with a weaker and stronger PFM contraction, nor between the types of vaginal palpation. Bidigital palpation increased women’s perception, made the contraction easier, and was associated with less space in the vaginal canal and less comfort.

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Funding

This study was funded by in part by Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior (CAPES); Finance Code 0001.

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Authors and Affiliations

  1. Women’s Health Research Laboratory, Physical Therapy Department, Federal University of São Carlos, Rodovia Washington Luís, km 235, Monjolinho, São Carlos, SP, 13565-905, Brazil

    Jordana Barbosa da Silva, Ana Paula Rodrigues Rocha & Patricia Driusso

  2. Preventive Physical Therapy and Ergonomics Laboratory, Physical Therapy Department, Federal University of São Carlos, Rodovia Washington Luís, km 235, Monjolinho, São Carlos, SP, 13565-905, Brazil

    Tatiana de Oliveira Sato

Authors
  1. Jordana Barbosa da Silva
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  2. Ana Paula Rodrigues Rocha
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  3. Tatiana de Oliveira Sato
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  4. Patricia Driusso
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Contributions

JBS: substantial contributions to conception and design, drafting and revising the article critically for important intellectual content, final approval of the version to be published; APRR: substantial contributions to conception and design, drafting and revising the article critically for important intellectual content, final approval of the version to be published; TOS: substantial contributions to conception and design, drafting and revising the article critically for important intellectual content, final approval of the version to be published; PD: substantial contributions to conception and design, drafting and revising the article critically for important intellectual content; 3) Final approval of the version to be published.

Corresponding author

Correspondence to Jordana Barbosa da Silva.

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Ethical approval

This study was approved by the Ethics and Research Committee of the Federal University of São Carlos (CAAE: 51999415.9.0000.5504).

Conflicts of interest

The authors declare that there are no conflicts of interest.

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da Silva, J.B., Rocha, A.P.R., Sato, T.d.O. et al. Is there agreement between the preference of examiner and women for unidigital and bidigital vaginal palpation? A qualitative study. Int Urogynecol J 32, 3293–3299 (2021). https://doi.org/10.1007/s00192-021-04935-3

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  • DOI: https://doi.org/10.1007/s00192-021-04935-3

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