Table 2 Physical Examination Components [25]
Part of the Body | Typical Findings |
|---|---|
Abdominal examination | Tenderness from colonic distension due to fecal impaction |
Digital rectal examination | Rectal distension [full of stool], insight into perianal sensation, and anal sphincter tone |
External urological and perianal examination | Presence of a mucosal web or skin tags around the external urethral meatus [13, 22], hypospadias [displacement of the meatus to the anterior vaginal wall] [13], labial adhesions in girls, signs of skin excoriation, or redness indicating severe or continuous urinary leakage |
Lower back | Cutaneous markers of occult sacral agenesis or spinal dysraphism [presacral dimple, lipoma, hair tuft, asymmetric gluteal cleft] |
Neurologic examination | Lower limb strength, deep tendon reflexes, gait, fine-motor coordination, anal and perineal sensation, rectal tone assessment |
Urinary stream observation | hesitancy, straining, prolonged voiding time, weak or intermittent stream, especially during observed voiding, anterior directed urinary stream [ADUS] |
Perianal inspection | location of the anus, presence of gluteal cleft asymmetry, dermatitis and perianal fissures, feces or hemorrhoids |