Pelvic floor and sexual male dysfunction

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.

EPIDEMIOLOGY OF THE LOWER URINARY TRACT DYSFUNCTIONS IN THE FEMALE DIABETIC POPULATION

The authors deal with “female diabetic cystopathy” with particular regard to the incidence of the most frequent disorders that characterise the syndrome. The study was carried out on 255 patients, in collaboration with outpatients’ surgeries specialised in diabetes. Other aspect s specially emphasized were the association of vesicourethral functional disorders with alterations of the pelvic statics and the severity of the symptoms in relation to the age of the patients and the duration of their diabetes.

Anatomy and nerve supply of the pelvic floor

In order to guarantee urinary and fecal continence as well as correct pelvic statics, the perfect neuroanatomical integrity of the pelvic floor muscles is mandatory. As Dickinson stated: “There is no considerable muscle in the body whose form and function are more difficult to understand than those of the levator ani, and about which such nebulous impressions prevail”. Clinical implications of pelvic floor anatomy and nerve supply are evident: a denervation of this muscle group and the consequent muscle dysfunction could result in urinary and/or fecal incontinence, as well as pelvic organ prolapse.