The pelvic muscles and surrounding nerves control many aspects of urinary and bowel function. When a woman experiences urinary incontinence, bowel incontinence, pelvic pain or other problems in the pelvic region, our specialists can diagnose the underlying condition through a series of testing procedures. As the only dedicated section of urogynecology in the Riverside and San Bernadino county area, the Section of Urogynecology at Loma Linda University Medical Center is equipped with state of the art testing equipment and regularly provides diagnosis and treatment to women suffering from pelvic floor conditions.

Anal manometry, EMG and pudendal nerve motor latency are types of electrophysiology studies used to determine the cause of bowel incontinence or constipation. Bowel incontinence can be caused by the weakening of the anal sphincters, the pelvic floor muscles or by other urogynecologic conditions.

Anal Manometry Procedure
During this study, a soft balloon is placed in the rectum. In order to measure the sensitivity of the rectum and anus, the balloon is slowly inflated with fluid. This also tests the proper function of the rectal reflexes. To measure the pressure in the various parts of the rectum and anal canal, a catheter is slowly pulled through the anus. The patient is asked to squeeze, relax and possibly to try and expel the balloon.

EMG Procedure (Electromyography)
During the EMG, a small electrode is placed in the anal canal to record sphincter and pelvic floor muscle activity. The patient is asked to relax, squeeze and push at different times and the muscle activity is recorded and displayed on a computer screen. This study tests for proper muscle contractions in the anus.

Pudendal Nerve Motor Latency Procedure
The pudendal nerve motor latency test determines whether or not the patient's pudendal nerve is functioning properly. The pudendal nerve is located in the pelvis and, when malfunctioning, may cause urinary or bowel incontinence. During the procedure, an electrode pad is placed on the patient's buttock or thigh. The physician administering the procedure wears a rubber glove with an electrode on the finger. This is inserted into the patient's rectum and a mild electrical stimulus is sent through the electrode on the finger to the pudendal nerve. A computer records the nerve's response and the test results will show if there are any problems in the nerve's communication system.