scholarly journals Neural control of the female urethral and anal rhabdosphincters and pelvic floor muscles

2010 ◽  
Vol 299 (2) ◽  
pp. R416-R438 ◽  
Author(s):  
Karl B. Thor ◽  
William C. de Groat
Keyword(s):  
Pelvic Floor ◽  
Motor Neurons ◽  
Basic Science ◽  
Neural Control ◽  
Levator Ani ◽  
Pelvic Floor Muscles ◽  
Urinary Continence ◽  
Onuf's Nucleus ◽  
Onuf’S Nucleus ◽  
Pelvic Muscles

The urethral rhabdosphincter and pelvic floor muscles are important in maintenance of urinary continence and in preventing descent of pelvic organs [i.e., pelvic organ prolapse (POP)]. Despite its clinical importance and complexity, a comprehensive review of neural control of the rhabdosphincter and pelvic floor muscles is lacking. The present review places historical and recent basic science findings on neural control into the context of functional anatomy of the pelvic muscles and their coordination with visceral function and correlates basic science findings with clinical findings when possible. This review briefly describes the striated muscles of the pelvis and then provides details on the peripheral innervation and, in particular, the contributions of the pudendal and levator ani nerves to the function of the various pelvic muscles. The locations and unique phenotypic characteristics of rhabdosphincter motor neurons located in Onuf's nucleus, and levator ani motor neurons located diffusely in the sacral ventral horn, are provided along with the locations and phenotypes of primary afferent neurons that convey sensory information from these muscles. Spinal and supraspinal pathways mediating excitatory and inhibitory inputs to the motor neurons are described; the relative contributions of the nerves to urethral function and their involvement in POP and incontinence are discussed. Finally, a detailed summary of the neurochemical anatomy of Onuf's nucleus and the pharmacological control of the rhabdosphincter are provided.

scholarly journals Episiotomy: the biomechanical impact of multiple small incisions during a normal vaginal delivery

2019 ◽  
Vol 9 (5) ◽  
pp. 20190027 ◽  
Author(s):  
Dulce Oliveira ◽  
Maria Vila Pouca ◽  
João Ferreira ◽  
Teresa Mascarenhas
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Symphysis Pubis ◽  
Pelvic Floor Muscles ◽  
Point Of View ◽  
Normal Vaginal Delivery ◽  
Tissue Integrity ◽  
Levator Trauma ◽  
Reaction Forces

Childbirth-related injuries are one of the main causes of pelvic floor dysfunction. To attempt to avoid serious tears during delivery, an episiotomy can be performed. In this study, we intended to investigate the biomechanical performance of the pelvic floor muscles after performing different episiotomies using a physics-based computational model which includes the pelvic floor muscles and the fetus. Previous biomechanical studies have analysed the mechanical effects of single incisions of different lengths; in this study, we intend to analyse the implications of multiple small incisions, evaluating the reaction forces, the stress on the muscles and the loss of tissue integrity sustained by the pelvic floor. The obtained results predict that an episiotomy delivery reduces the likelihood of macroscopic levator trauma by decreasing the stress on the region of insertion of the rectal area of the levator ani in the symphysis pubis . From the mechanical point of view, multiple incisions do not bring benefits compared to larger incisions. However, nothing can be ascertained about the clinical benefit of such an approach.

scholarly journals P26.02: Correlation of ultrasound evidence of levator ani trauma with clinical functional testing of pelvic floor muscles

2010 ◽  
Vol 36 (S1) ◽  
pp. 269-270
Author(s):  
A. Bord ◽  
S. Yagel ◽  
L. Shick-Naveh ◽  
M. Lipschuetz ◽  
R. Drai-Hassid ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Levator Ani ◽  
Pelvic Floor Muscles ◽  
Functional Testing ◽  
Ultrasound Evidence

scholarly journals Effect of Postpartum Pelvic Floor Muscles Training in Pelvic Floor Muscles Strength on Postpartum Women with Stress Urinary Incontinence

2018 ◽  
pp. 114
Author(s):  
Jerisatrio S Tarukallo ◽  
David Lotisna ◽  
Nugraha U Pelupessy
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Muscles ◽  
P Value ◽  
Postpartum Women ◽  
Perineal Tear ◽  
International Consultation ◽  
Pelvic Floor Training ◽  
Significant Difference ◽  
Pelvic Muscles

Objective: To evaluate the effect of pelvic floor training (Kegelexercise) on pelvic floor muscle strength in postpartum womenwith SUI.Methods: Thirty-five birth vaginally postpartum women with SUIwere experimentally enrolled. After four weeks of postpartumobservation, the diagnosis of SUI confirmed, and all of these womenwere asked to complete the International Consultation onIncontinence Questionnaire-Sort Form (ICIQ-SF) questionnaire.The strength of the pelvic floor muscle measured with perineometerevery once in 3 weeks for 12 weeks of Kegel exercise. SUI severityassessed with ICIQ-SF after completing the Kegel exercise. A pairedt-test was used to compare measurement results between ICIQ-SFquestionnaire and perineometer and multiple linear regressionmodels was used for multivariate analysis. A p value of less than 0.05was taken to be statistically significant.Results: Findings show a significant difference between clinicalvariables (parity, neonates birth weight, perineal tear grade, BMI)and the improvement of pelvic floor muscles before and afterperformed the Kegel exercise (all p<0.05). The pelvic floormuscles strength significantly improved (p=0.000) after Kegelexercise both in ICIQ-SF questionnaire and perineometermeasurement.Conclusion: Pelvic muscles floor training or Kegel exercise improvepelvic muscles floor strength in postpartum women with SUI.[Indones J Obstet Gynecol 2018; 6-2: 114-118]Keywords: pelvic muscles floor training, postpartum, stress urinaryincontinence

FUNCTIONAL ASPECTS OF THE FEMALE PELVIC FLOOR MUSCLES IN URINARY CONTINENCE

2008 ◽  
Vol 7 (3) ◽  
pp. 314
Author(s):  
C. Wallner ◽  
N.F. Dabhoiwala ◽  
M.C. Deruiter ◽  
W.H. Lamers
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Muscles ◽  
Urinary Continence ◽  
Female Pelvic Floor ◽  
Functional Aspects

scholarly journals Management of Dyspareunia and Associated Levator Ani Muscle Overactivity

2007 ◽  
Vol 87 (7) ◽  
pp. 935-941 ◽  
Author(s):  
Kimberly A Fisher
Keyword(s):  
Pelvic Floor ◽  
Rating Scale ◽  
Physical Therapist ◽  
Management Strategies ◽  
Levator Ani ◽  
Pelvic Floor Muscles ◽  
Future Research ◽  
Levator Ani Muscle ◽  
Home Based ◽  
And Function

Background and PurposeMusculoskeletal dysfunction is a known cause of dyspareunia and a reason for referral for physical therapist management. The purpose of this case report is to describe the physical therapist management of a patient with dyspareunia and overactivity of the pelvic-floor muscles with a limited number of visits and a focus on self-management strategies.Case DescriptionThis case involved a 30-year-old married woman with levator ani muscle overactivity and dyspareunia that was 1 year in duration.InterventionThe therapist explained the anatomy and function of the pelvic-floor muscles during intercourse, instructed the patient on how to control the levator ani muscles, and instructed her on vaginal self-dilation techniques.OutcomesThe patient attended 3 physical therapy sessions over a period of 9 weeks. She performed vaginal self-dilation at home. She rated pain during intercourse as 0/10 on a verbal rating scale and had no remaining tenderness in the levator ani muscles at discharge.DiscussionSome women with dyspareunia may improve with an intervention that emphasizes education and vaginal self-dilation techniques. Future research should compare home-based and clinic-based treatments.

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