ABPTS WMS key terms

A partial or complete detachment of the pubovisceral portion of the levator ani muscle from its attachment on the pubic bone, most often caused by vaginal birth and detectable on palpation or imaging.

The opening in the pelvic floor bounded by the levator ani through which the urethra, vagina, and rectum pass; its dimensions widen with muscle injury, prolapse, and pregnancy.

Descent of the bladder, uterus, or rectum into or beyond the vagina due to loss of connective tissue and muscular support, graded by the leading edge relative to the hymen.

A standardized measurement system that quantifies prolapse using six defined vaginal points referenced to the hymen, producing stages from zero (no prolapse) through four (complete eversion).

Involuntary urine loss occurring with increases in intra-abdominal pressure such as coughing, sneezing, or lifting, typically reflecting urethral sphincter or support deficiency.

Involuntary urine loss accompanied by or immediately preceded by a sudden compelling desire to void that is difficult to defer, often related to detrusor overactivity.

A prospective record kept over several days documenting voiding times, volumes, fluid intake, leakage episodes, and urgency sensations, used to characterize continence patterns and guide treatment.

A behavioral program that uses scheduled voiding intervals and gradual interval lengthening to restore normal bladder capacity and reduce urgency and frequency.

A structured, progressive exercise program of repeated voluntary pelvic floor contractions with attention to correct technique, prescribed to improve support, continence, and function.

A device that measures vaginal squeeze pressure or force during pelvic floor contraction, used for biofeedback, motivation, and tracking progress in muscle training programs.

Use of instrumented signals such as pressure, electromyography, or ultrasound imaging to give a patient real-time information about pelvic floor muscle activity, supporting motor learning and technique correction.

A voluntary pre-contraction of the pelvic floor muscles performed just before a cough, sneeze, or lift to reduce urine leakage during anticipated increases in abdominal pressure.

A removable silicone device inserted into the vagina to support descended organs or to compress the urethra, offering a nonsurgical option for prolapse or incontinence management.

The clinical process of selecting device size and shape, confirming comfort and symptom relief, teaching insertion and removal, and scheduling periodic checks for erosion or discharge.

An abnormal widening or thinning of the linea alba between the rectus abdominis muscles, commonly measured in pregnancy and postpartum and addressed through graded loading and trunk stabilization exercise.

The midline fibrous band of the anterior abdominal wall where the aponeuroses of the abdominal muscles interlace, providing tensile continuity between the left and right sides.

A grading system for obstetric lacerations: first degree involves vaginal mucosa or perineal skin, second involves perineal muscle, third involves the anal sphincter complex, and fourth extends into anal epithelium.

Third- or fourth-degree perineal trauma involving the anal sphincter complex, a major risk factor for fecal incontinence and pelvic floor dysfunction after childbirth.

Involuntary loss of solid or liquid stool or flatus, frequently arising from sphincter injury, neuropathy, or impaired rectal sensation, and managed with muscle training, bowel scheduling, and diet modification.

A test that measures anal sphincter pressures, rectal sensation, and rectoanal reflexes using a pressure-sensing catheter, informing diagnosis and prognosis of defecatory and continence disorders.

Impaired coordination in which pelvic floor and anal sphincter muscles fail to relax or paradoxically contract during attempted defecation, causing obstructed bowel movements and straining.

An inappropriate increase in puborectalis muscle activity during straining to defecate, narrowing the anorectal angle when relaxation is required, a key mechanism in dyssynergic defecation.

The somatic nerve supplying the external urethral and anal sphincters and perineal sensation, vulnerable to stretch injury and entrapment that can impair continence and pelvic floor function.

Pain in the region of the posterior iliac crest, gluteal fold, or symphysis pubis, often with difficulty walking or turning in bed, commonly arising in pregnancy and the postpartum period.

Pain and instability at the anterior pelvic joint during pregnancy or postpartum, provoked by standing on one leg, walking, or widening the legs, and managed with support and stabilization exercise.

An external support worn around the pelvis that compresses the pelvic ring to reduce pain and improve walking tolerance in people with pelvic girdle pain.

Low back pain arising during pregnancy or within the postpartum period, attributed to mechanical, hormonal, and postural changes rather than to a specific spinal pathology.

Stretching and massage of the perineal tissues performed in late pregnancy to improve tissue compliance and reduce the likelihood of obstetric tearing or episiotomy.

A staged return to activity after childbirth that begins with breathing and pelvic floor activation, advances through functional loading, and respects tissue healing, symptoms, and fatigue.

A criteria-based progression for resuming high-impact activity after birth, requiring adequate pelvic floor function, load tolerance, and symptom-free single-leg and impact testing.

A validated questionnaire completed by the patient that quantifies symptoms, function, or quality of life, used to establish baseline status and demonstrate change over an episode of care.

The smallest change in an outcome score that a patient would perceive as meaningful, used to interpret whether measured improvement exceeds measurement error.

The process of disclosing the nature, risks, benefits, and alternatives of proposed care, confirming understanding, and obtaining voluntary agreement before proceeding, including for sensitive pelvic examinations.

The legally defined boundaries of assessment and intervention a clinician may perform based on licensure, training, and jurisdiction, including whether internal pelvic examination is permitted.

A third person present during a sensitive examination or treatment who protects both patient and clinician, offered to patients as part of respectful, ethical pelvic health care.

Systematically developed recommendations based on a review of evidence that guide decisions about assessment and care for a defined condition and population.

A ranking that reflects the methodological strength of a study design, from systematic reviews of trials down through single case reports, used to weigh confidence in a recommendation.

The baseline pressure or tone in the vaginal canal when the pelvic floor is relaxed, measured to characterize muscle function before and after voluntary contraction.

A cluster of examination maneuvers that reproduce pain from pelvic joints or tissues, used to identify the source of symptoms and guide targeted intervention.