scholarly journals Attachment of the levator ani muscle extends to the superior ramus of the pubic bone through electrophysiological and anatomical examinations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hung-Yen Chin ◽  
Chih-Wei Peng ◽  
Ming-Ping Wu ◽  
Chih-Hwa Chen ◽  
Yu-Ting Feng ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Pelvic Floor Muscle ◽  
Levator Ani ◽  
Pubic Bone ◽  
Levator Ani Muscle ◽  
Cadaver Dissection ◽  
Inferior Border ◽  
Stimulation Of

AbstractMyofascial pelvic pain (MFPP) of pelvic floor muscles is a common cause of chronic pelvic pain (CPP). The pathological mechanisms and treatments of MFPP are complex and still unclear until now. The levator ani muscle (LAM) is the major pelvic floor muscle. The purpose of this study was to examine the fascia and attachment of LAM through the electromyogram (EMG) and cadaver dissection. Electrophysiological stimulation of the obturator fascia above the arcus tendinous levator ani (ATLA) could trigger contraction and electrophysiological changes in LAM insertion. The LAM of embalmed adult cadavers was examined especially in the area above the ATLA. Some skeletal muscle fibers were found above the ATLA within the obturator fascia and were confirmed by Masson’s trichrome section staining. Our electromyography (EMG) and anatomical data implied that the attachment of LAM aponeurosis extended beyond ATLA to the inferior border of the superior ramus of the pubic bone. The new discovered attachment of LAM could provide a reference position for clinical diagnosis and treatment of MFPP or CPP.

623 THIELE MASSAGE AS POSSIBLE THERAPEUTIC INTERVENTION FOR WOMEN WITH CHRONIC PELVIC PAIN CAUSED BY TENDERNESS OF THE LEVATOR ANI MUSCLE

2009 ◽  
Vol 13 (S1) ◽  
Author(s):  
M. Montenegro ◽  
E. Vasconcelos ◽  
J.C. Rosa‐E‐Silva ◽  
F. Candido‐Reis ◽  
A. Nogueira ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Therapeutic Intervention ◽  
Chronic Pelvic Pain ◽  
Levator Ani ◽  
Levator Ani Muscle

scholarly journals Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

2012 ◽  
Vol 130 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Bruno Teixeira Bernardes ◽  
Ana Paula Magalhães Resende ◽  
Liliana Stüpp ◽  
Emerson Oliveira ◽  
Rodrigo Aquino Castro ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Controlled Trial ◽  
Levator Ani ◽  
Pelvic Organ ◽  
Levator Ani Muscle ◽  
Muscle Training ◽  
Randomized Controlled

CONTEXT AND OBJECTIVE: Previous studies have shown that women with pelvic floor dysfunctions present decreased cross-sectional area (CSA) of the levator ani muscle. One way to assess the effects of training programs is to measure the CSA of the muscle, using ultrasonography. The aim here was to evaluate the efficacy of pelvic floor muscle training and hypopressive exercises for increasing the CSA of the levator ani muscle in women with pelvic organ prolapse. DESIGN AND SETTING: Prospective randomized controlled trial at the Urogynecology outpatient clinic of Universidade Federal de São Paulo. METHODS: Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI); a hypopressive exercise group (GII); and a control group (GIII). The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA) of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment. RESULTS: The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001), but not in relation to GIII (P = 0.816). CONCLUSIONS: The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle.

scholarly journals Postpartum sexual function; the importance of the levator ani muscle

2020 ◽  
Vol 31 (11) ◽  
pp. 2261-2267
Author(s):  
Anne-Marie Roos ◽  
Leonie Speksnijder ◽  
Anneke B. Steensma
Keyword(s):  
Regression Analysis ◽  
Sexual Dysfunction ◽  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Sexual Functioning ◽  
Pelvic Floor Muscle ◽  
Linear Regression Analysis ◽  
Levator Ani ◽  
Transperineal Ultrasound ◽  
Levator Ani Muscle

Abstract Introduction and hypothesis Pelvic floor muscle function plays an important role in female sexual functioning. Smaller genital hiatal dimensions have been associated with sexual dysfunction, mainly dyspareunia. On the other hand, trauma of the levator ani muscle sustained during childbirth is associated with increased genital hiatus, which potentially can affect sexual functioning by causing vaginal laxity. This study aims to determine the association between levator hiatal dimensions and female sexual dysfunction after first vaginal delivery. Methods This is a secondary analysis of a prospective observational study. Two hundred four women who had a first, spontaneous vaginal delivery at term between 2012 and 2015 were recruited at a minimum of 6 months postpartum. Thirteen pregnant women were excluded. We analyzed the association of total PISQ-12 score, as well as individual sexual complaints (desire, arousal, orgasm and dyspareunia), with levator hiatal dimensions at rest, with maximum Valsalva and during pelvic floor muscle contraction as measured by 4D transperineal ultrasound. Statistical analysis was performed using linear regression analysis and Mann-Whitney U test. Results One hundred ninety-one women were evaluated at a median of 11 months postpartum. There was no significant association between total PISQ-12 score and levator hiatal dimensions. Looking at individual sexual complaints, women with dyspareunia had significantly smaller levator hiatal area and anterior-posterior diameter on maximum Valsalva. By using multivariate logistic regression analysis however we found dyspareunia was not independently associated with levator hiatal dimensions. Conclusions After first vaginal delivery sexual dysfunction is not associated with levator hiatal dimensions as measured by 4D transperineal ultrasound.

Ultrasonic Diagnosis and Analysis of the Effect of Labor Analgesia on Early Pelvic Floor Function and Pelvic Floor Dysfunction

2021 ◽  
Vol 11 (7) ◽  
pp. 1903-1910
Author(s):  
Xiaolan Wang ◽  
Fan Yang ◽  
Wenjuan Chen ◽  
Xiaohong Yuan
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Pelvic Floor Muscles ◽  
Labor Analgesia ◽  
Natural State ◽  
Levator Ani Muscle ◽  
Pelvic Floor Function ◽  
Floor Function

Pelvic floor dysfunction disease (PFD) is a common pelvic organ dysfunction disease in the clinic of obstetrics and gynecology. Its cause is mainly the damage, defects and dysfunction of the pelvic floor support structure. Not only is the pathogenesis complicated, but also various symptoms coexist, which seriously affects the physical and mental health of female patients. Mechanical injury of the pelvic floor fascia tissue and levator ani muscles is the anatomical basis of PFD after birth; early postpartum pelvic floor examination and treatment can prevent and control the occurrence or development of PFD. Spinal canal anesthesia has good analgesic effect during labor and delivery, has little effect on mothers and infants, and is widely used. However, there are few domestic and foreign reports on the effect of labor analgesia on the pelvic floor. Labor analgesia relaxes the pelvic floor muscles, unblocks the birth canal, and the influence on the pelvic floor muscles is worth exploring. Based on the pelvic floor muscle strength screening to understand the changes in the function of the pelvic floor muscles, combined with the three-dimensional pelvic floor ultrasound examination, the pelvic floor structure and the levator ani muscle are clearly imaged, and the pelvic floor muscle structure is evaluated in the natural state and the analgesic muscle relaxation state. This study used a combination of the two to evaluate the effect of labor analgesia on pelvic floor function of primiparous women; provide individualized intervention treatment for high-risk groups screened; provide clinical basis for the prevention and treatment of PFD.

scholarly journals A Simulation Analysis of Maternal Pelvic Floor Muscle

2021 ◽  
Vol 18 (20) ◽  
pp. 10821
Author(s):  
Rongrong Xuan ◽  
Mingshuwen Yang ◽  
Yajie Gao ◽  
Shuaijun Ren ◽  
Jialin Li ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Levator Ani ◽  
Stress And Strain ◽  
Delivery Mode ◽  
Levator Ani Muscle ◽  
Pelvic Mri ◽  
Second Stage Of Labor ◽  
Attachment Point ◽  
Second Stage

Pelvic floor disorder (PFD) is a common disease affecting the quality of life of middle-aged and elderly women. Pelvic floor muscle (PFM) damage is related to delivery mode, fetal size, and parity. Spontaneous vaginal delivery causes especially great damage to PFM. The purpose of this study was to summarize the characteristics of PFM action during the second stage of labor by collecting female pelvic MRI (magnetic resonance imaging) data and, further, to try to investigate the potential pathogenetic mechanism of PFD. A three-dimensional model was established to study the influence factors and characteristics of PFM strength. In the second stage of labor, the mechanical responses, possible damage, and the key parts of postpartum lesions of PFM due to the different fetal biparietal diameter (BPD) sizes were analyzed by finite element simulations. The research results showed that the peak stress and strain of PFM appeared at one-half of the delivery period and at the attachment point of the pubococcygeus to the skeleton. In addition, during the simulation process, the pubococcygeus was stretched by about 1.2 times and the levator ani muscle was stretched by more than two-fold. There was also greater stress and strain in the middle area of the levator ani muscle and pubococcygeus. According to the statistics, either being too young or in old maternal age will increase the probability of postpartum PFM injury. During delivery, the entire PFM underwent the huge deformation, in which the levator ani muscle and the pubococcygeus were seriously stretched and the attachment point between the pubococcygeus and the skeleton were the places with the highest probability of postpartum lesions.

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