Functional anatomy of pelvic floor

Abstract

Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its multiple activities others than urological, gynaecological and intestinal ones. Recent acquirements succeeded in clarifying many aspects of pelvic floor activity, whose musculature has been investigated through electromyography, sonography, magnetic resonance, histology, histochemistry, molecular research. Utilizing recent research concerning not only urinary and gynecologic aspects but also those regarding statics and dynamics of pelvis and its floor, it is now possible to study this important body part as a unit; that means to consider it in the whole body economy to which maintaining upright position, walking and behavior or physical conduct do not share less than urinary, genital, and intestinal functions. It is today possible to consider the pelvic floor as a musclefascial unit with synergic and antagonistic activity of muscular bundles, among them more or less interlaced, with multiple functions and not only the function of pelvic cup closure.

Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy

“…Studies have shown that pelvic floor muscles (PFMs) together with internal oblique, intercostal muscles, transverse abdominal muscle, and diaphragm are responsible for maintaining proper body posture and breathing [32,33]. Due to numerous myofascial connections between PFM and other muscles all movements are functionally linked, and throughout this system, PFM exists as the basis for local stabilization [33,34]. For this reason, myofascial disorders as well as posture disorders can lead to impaired PFM function and, consequently, their weakness and UI [35].…”

Chemoradiation for cervical cancer treatment portends high risk of pelvic floor dysfunction

“…Radiotherapy is known to result in alterations of morphology and function of the female pelvic floor muscles (PFMs) [6]. The PFMs play an essential role in pelvic organ support, the maintenance of continence and are also associated with healthy sexual function [7][8][9].…”

Avaliação do equilíbrio postural em mulheres continentes e incontinentes

“…Desde que o homem evoluiu para a postura ereta, os MAP tornaram-se responsáveis pelo suporte dos órgãos pélvicos principalmente durante variações da pressão intra-abdominal (NAGIB et al, 2005). A manutenção de uma postura correta da região pélvica, ou seja, uma pelve estaticamente equilibrada nos planos frontal, sagital e horizontal, torna-se um fator de contribuição para a continência nas situações de aumento da pressão abdominal, pois favorecerá que essa pressão seja igualmente transmitida à bexiga e à uretra proximal, mantendo, assim, a pressão uretral máxima maior que a vesical (MATHEUS et al, 2006;ROCCA ROSSETTI, 2016 MCLEAN, 2008;SAPSFORD et al, 2008;JUNGINGER et al, 2010); os músculos paravertebrais lombares (SAPSFORD et al, 2008;ROCCA ROSSETTI, 2016); retoabdominal, oblíquos interno e externo (MADILL; MCLEAN, 2008;KORELO et al, 2011), glúteo máximo (PESCHERS et al, 2001;SOLJANIK et al, 2012;ROCCA ROSSETTI, 2016) e dos adutores (PESCHERS et al, 2001).…”

“…O controle postural objetiva o equilíbrio postural, que é alcançado quando todas as forças que agem neste corpo, tanto externas como internas, estão controladas, o que permite que o corpo permaneça em uma posição desejada (equilíbrio estático) ou que se mova de maneira controlada (equilíbrio dinâmico) (MAKI; MCILROY, 1996;FREIRE et al, 2014). Evidências recentes sugerem que mulheres com incontinência urinária de esforço (IUE) aumentaram a atividade dos músculos do tronco quando submetidas a alterações do controle postural (ROCCA ROSSETTI, 2016).…”