The pelvic floor is a musculo-tendon structure that forms the lower closure of the pelvis. Its structures envelop the pelvic organs (bladder, uterus, vagina and rectum) supporting them. The pelvic floor therefore actively participates in the activity of the pelvic organs by intervening in the urinary, fecal, sexual and reproductive function.
Pregnancy, natural childbirth, chronic increase in abdominal pressure, hormonal changes during pregnancy or menopause; or surgery, obstetric or genital trauma, genitourinary infections and sexual dysfunctions, together with a genetic predisposition of the individual, can cause some deficits in the functionality of the pelvic floor.Notes on the anatomy of the female pelvic floor
The vulva is the outermost part of the genitals. It consists of a complex of cutaneous and mucous formations bounded at the front by the pubic symphysis (the forward joining point of the two pelvic bones), at the back by the anus and laterally by the inguinal folds.The most important anatomical formations contained in it are:The mount of VenusThe labia majoraThe labia minora
The labia minora are 2 flattened skin folds that join together in the midline delimiting the vestibule of the vagina. We consider:Side face (C)Medial face: forms the lateral wall of the vestibule of the vagina (H)The vestibule of the vagina
The vestibule of the vagina is a vulvar area between the labia minora, bounded at the front by the frenulum of the clitoris, followed by the external orifice of the urethra and the vaginal orifice, and by the posterior labial commissure (or fork). The innermost border is given by the margin of the hymenal residues and the lateral border by an ideal border, the so-called Hart’s line.The hymen
The hymen (from the Greek hymén, membrane) is a mucous membrane that extends from one side of the vagina to the other, partially or completely closing its access. It can have different shapes, be thin or thick, rigid or elastic.In its integrity, a sign of „virginity” in the past, it can be interrupted or torn even before the first intercourse, or not even in that case.
The Pelvis and the PerineumThe pelvis can be considered as divided into LARGE PELVI and SMALL PELVIThe term „pelvis” comes from the Greek and Latin and means cup or plate; it contains the pelvic viscera: the bladder, uterus and rectum
The lower strait is the opening found on the lower slope: this region is called the PERINEUM. The perineum is the set of soft parts that close the pelvis at the bottom.The perineum has a lozenge shape and is delimited anteriorly by the lower contour of the pubic symphysis, posteriorly by the coccyx and laterally by the two ischial tuberosities.
It also consists of a skin plane and a muscular plane (pelvic floor). The latter, while being more robust than other mammals, is more subjected to the stresses of the weight of the viscera and variations in endo-abdominal pressure.
The pelvic floor constitutes the bottom of the abdominal-pelvic cavity, on which the role of supporting the viscera, erecting the corpora cavernosa of the genitals and controlling continence rests.The dynamics of the pelvic organs is conditioned by 2 systems:SUPPORT SYSTEM
Made up of 3 muscle layers:
1. Deep represented by the „pelvic diaphragm” which is common to both the anterior perineal region and the posterior perineal region;
2. Intermediate represented by the „urogenital diaphragm” (or „urogenital trine” or perineal membrane) and is typical of the anterior perineal region;
3. More superficial, it is called „superficial plane of the perineum or tract of the sphincters”