Initial experience with a new method for the dynamic assessment of pelvic floor function in women: the Kolpexin Pull Test

The aim of this study was to evaluate a newly developed, simple test for assessing pelvic floor muscular function in women. Pelvic floor strength in women with symptomatic pelvic floor dysfunction was evaluated with a newly developed assessment tool, the Kolpexin Pull Test, and compared to a clinically validated digital pelvic floor strength assessment scale (DPA). A 36-mm Kolpexin sphere was inserted into the vagina above the levator plate and connected to a digital tensiometer/force gauge. The force required to remove the sphere was recorded for three resting trials and three maximum pelvic floor contractions. Results of the DPA and Kolpexin Pull Test were analyzed using ANOVAs of contrast variables, intraclass correlations, and regression analyses. Twenty-one women participated in the study. Age range was 36–85 years, parity range was 2–5. All six trials required less than 5 min to perform in each patient. Intraperson maximum contraction data were correlated at 0.96 (95% CI: 0.91, 0.98), and were greater at higher DPA scores (p=0.016). There were positive correlations between the maximum contraction and DPA data (adjusted R²=0.52; p <0.001), and the maximum contraction minus resting vs DPA data (adjusted R²=0.54; p< 0.001). The Kolpexin Pull Test is reproducible, rapid, and correlates with digital clinical assessment of pelvic floor strength during maximal contractions.Abbreviations DPA Digital pelvic assessment - MC Maximum pelvic floor contraction - RP Relaxed pelvic floor Editorial Comment: This paper is an interesting pilot study of a new technique to measure pelvic muscle strength. Several other techniques have already been described. As the authors have stated, all methods have flaws, including the relatively easy and reproducible digital pelvic assessment (DPA). The Kolpexin sphere offers the hope of more objective testing than the DPA, overcomes the contribution of Valsalva to the pressure perineometry readings, and is easier to perform than ultrasound or EMG. The authors did not fully convince us of the objectivity of the measurements, as the study was not blinded. Also, we do not know whether the size of the sphere altered the readings in women in different heights and/or weights. If, on further testing, this technique is shown to have inter- as well as intraexaminer reproducibility, it may contribute to the evaluation of patients for management as well as for research.