Pelvic floor and sexual male dysfunction

Abstract

The pelvic floor is a complex multifunctional structure that corresponds to the genito-urinary-anal area and consists of muscle and connective tissue. It supports the urinary, fecal, sexual and reproductive functions and pelvic statics. The symptoms caused by pelvic floor dysfunction often affect the quality of life of those who are afflicted, worsening significantly more aspects of daily life. In fact, in addition to providing support to the pelvic organs, the deep floor muscles support urinary continence and intestinal emptying whereas the superficial floor muscles are involved in the mechanism of erection and ejaculation. So, conditions of muscle hypotonia or hypertonicity may affect the efficiency of the pelvic floor, altering both the functionality of the deep and superficial floor muscles. In this evolution of knowledge it is possible imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life.

The role of the pubococcygeus muscle in the urethrogenital reflex of male rats

“…Importantly, the transection of the caudal branch of the Smb does not abolish the reflex activity of both the Bsm and the Icm in reponse to the penile stimulation or the UGR. It may be that the inactivity of the Pcm reduces the UP and delays ejaculation, which could be related to the reduced fertility ratio reported by other authors, and even to some sexual dysfunctions like retrograde ejaculation . The contraction of the Bsm and Icm could be thus helpful for maintaining ejaculation after the denervation of the Pcm.…”

“…Pelvic floor muscles, such as the pubococcygeus muscle (Pcm), play important roles in male sexual function . Both contraction and relaxation of the Pcm are important for penile erection and ejaculation . Indeed, the activation of the Pcm by exercise has been effective as a treatment for erectile dysfunction …”

Pelvic muscle floor rehabilitation as a therapeutic option in lifelong premature ejaculation: long-term outcomes

“… 16 17 18 19 Research evidence has supported a possible active role of the PFMs, particularly the ischiocavernosus and bulbocavernosus muscles and sphincters, in the control of ejaculation, as confirmed by a significant increase in electromyography activity during the entire physiological process. 20 As we have previously reported, 15 21 physiokinesiotherapy and electrostimulation are designed to improve the contractile strength of the perineal muscles, whereas biofeedback is used to facilitate patients’ learning to recognize and contract PFMs to increase the closing strength of the urethral sphincter. However, PFM training does require a few months for a patient to understand the dynamics of the sequence of events, learn to control the ejaculatory reflex and naturally apply this learning during sexual intercourse.…”

713 Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: A novel therapeutic approach

“…The pelvic floor undoubtedly plays an important role in sexual function; evidence suggests active roles of the ischiocavernous and bulbocavernous muscles, and sphincters, with a significant increase in electromyographic activity during the entire ejaculatory period [Pischedda et al 2013]. Shafik demonstrated rhythmic contractions of the external striated urethral sphincter during expulsion, which may act like a suction-ejection pump, sucking the seminal fluid into the posterior urethra while relaxed and ejecting it into the bulbous urethra upon contraction [Shafik, 2000].…”