Chapter 4 114 dyssynergia? The pelvic floor physical therapist will evaluate therapy with his/her own DRE with or without s-EMG, not with ARM or transperineal ultrasound. Perhaps we should only perform anorectal function tests in patients who are refractory to conservative treatment like lifestyle and pelvic floor physical therapy, or when more invasive procedures like surgery or botulinum toxin e.g., are considered. Furthermore, these tests are valuable when evaluating new (surgical) therapies. Conclusion This study shows that DRE has a good correlation amongst experienced investigators. Since commonly performed anorectal function tests correlate poorly with DRE, and with other anorectal function tests, DRE by an experienced investigator suffices in daily clinical practice. When conservative treatment fails, further investigation is warranted, however these results should be interpreted with caution.
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