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.

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].…”

“…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].…”

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

“…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, 5 and even to some sexual dysfunctions like retrograde ejaculation. 8,23 The contraction of the Bsm and Icm could be thus helpful for maintaining ejaculation after the denervation of the Pcm.…”

“…4,6 Both contraction and relaxation of the Pcm are important for penile erection and ejaculation. 4,7,8 Indeed, the activation of the Pcm by exercise has been effective as a treatment for erectile dysfunction. 7 In male rats, the Pcm is the largest skeletal muscle of the pelvic floor.…”

The role of physiotherapy in the treatment of men’s sexual dysfunction (erectile dysfunction and premature ejaculation): a review

“…in addition to exercise, biofeedback and electrical stimulation can also be used to retrain and improve PFM function [25]. Electrical stimulation can be applied directly on the PFM ventricle (by rectal electrode), as well as through the pudendal nerve (an electrode on the S2-S4 nerves and another one in the anus or on the perineum area).…”