Obstetrical Pelvic Trauma Assessment

Screening and Treatment for Pelvic Trauma from Childbirth Exclusively at St. Luke’s

The OPTA program provides proactive screening, intervention and treatment for pelvic trauma due to childbirth. The OPTA program is the first such program in the nation and offered exclusively at St. Luke’s. This unique program focused on assessing and preventing pelvic floor disorders.

After you deliver your baby, your obstetrician will assign you an OPTA “score” which will categorize you as low risk, at risk or high risk. If you are determined to be “at risk” or “high risk” to develop a pelvic floor disorder, you will be referred to the new OPTA program.  You will be given a referral form upon discharge from the hospital asking you to make an appointment with St. Luke’s when you return home.  The CPH staff will then provide you with an appointment somewhere between three and six months after your delivery.

The OPTA score is only a screening tool to help refer women for evaluation immediately after delivery; Women who are not automatically referred for evaluation may develop symptoms within the first twelve months post-partum and may seek evaluation at the CPH by their own request or by their obstetrician’s referral.

Five Signs of Pelvic Trauma

  1. Leakage of urine with cough, sneeze or exercise
  2. Difficulty making it to the bathroom in time
  3. Difficulty pushing out a bowel movement or loss of stool
  4. A change in sensation with intercourse (either pain or lack of sensation)
  5. The feeling of something dropping or bulging down the vagina

OPTA Consultation

Your first consultation visit will be about an hour and you will meet with the specially-trained nurses. The visit will include a medical and obstetrical history, a pelvic floor examination to assess pelvic muscle strength and vaginal support and select office testing.

In this first visit, you will receive:

  • An individualized “pelvic floor plan” with educational materials about pelvic floor disorders unique to your condition
  • Prevention strategies for further pelvic floor defects. This may even include recommendations about your next delivery if you become pregnant again.

A summary of your consultation visit and plan for any further care will be shared with your obstetrician, and together you can manage your long-term pelvic floor health.

Please remember, pelvic floor disorders are not a normal result of childbirth.  Things you do to protect and strengthen your pelvic floor today can help ensure pelvic floor health tomorrow.

Diagnostic and Testing Options

  • Uroflowmetry to assess urination pattern
  • Bladder ultrasound scanning to assess bladder emptying without catheterization
  • Endoanal ultrasound to assess the anal sphincter muscles through imaging
  • Urodynamic testing to assess bladder function during storage and urination
  • Anal manometry to assess strength of the anal sphincter muscles
  • Pelvic floor muscle strength assessment
  • Evaluation for pelvic floor and urethral support defects
  • Dietary counseling for both urinary and rectal symptoms
  • Lifestyle modifications (nutritionist, smoking cessation, Pilates, etc.)
  • Biofeedback and electrical stimulation therapy (muscle strengthening and coordination)
  • Physical therapy for muscle relaxation and pelvic or vulvar pain
  • Referral to a physician for further medical or surgical treatment

Fees and Insurance

Most insurance companies will cover most or all of the costs of the tests and treatments described above.  We participate in most major managed health care plans.  If you have questions about your coverage, check your insurance company or plan.  Our staff will be happy to help you with claim processing and any other questions.