At the bottom of the pelvic cavity is the muscular pelvic floor constructed of connective tissue. The pelvic floor is known for the pelvic floor weakness that often occurs in women.
What is the pelvic floor?
The pelvic floor is the floor of the pelvic cavity in humans, which consists of connective tissue and muscle. Among other things, the pelvic floor is formed by the so-called “Musculus levator ani” (lifter of the anus). In quadrupedal mammals, the term pelvic floor refers to the area of the ventral surface formed between the pubic and ischial bones in the bony pelvis, due to the posture and position of the pelvis. In humans, the respective posterior termination of the pelvic cavity is referred to as the so-called retroperitoneal portion of the pelvic cavity.
Anatomy and structure
The pelvic floor is divided into three parts: The pelvic diaphragm, the urogenital diaphragm, and the sphincter and corpora cavernosa. The diaphragma pelvis is the posterior part of the pelvic floor, diaphragma urogenitale is the anterior part of the pelvic floor. These are muscular plates, the mechanical center of the pelvic floor is the centrum tendineum, which is a tendinous connection. The pelvic diaphragm is the inner muscular layer of the pelvic floor, which serves to close or lift the anus. The urogenital diaphragm is a plate about 1 cm thick, consisting of muscles and connective tissue, located between the lower branches of the os pubis (pubic bone) and the tuber ischiadicum (ischial tuberosity).
Function and tasks
The three main functions of the pelvic floor are tension, relaxation, and reflex counter-holding (tension as a possible response to an increase in pressure present in the abdomen). In both women and men, tension serves to ensure continence. The muscles of the pelvic floor support the lower part of the urethra and the sphincters of the bladder and anus. The relaxation of the pelvic floor occurs, among other things, during defecation, urination and, in both men and women, during sexual intercourse. During orgasm, pulsation of the pelvic floor causes an alternation between tension and relaxation. Reflective counter-holding by the pelvic floor usually occurs during sneezing and coughing, laughing, bouncing, and carrying heavy loads. If reflex counter-holding is not possible, then loss of urine usually occurs.
Diseases, complaints and disorders
The pelvic floor – regardless of gender – is usually weakened by obesity, by chronic physical overload, by poor posture, by surgery in the pelvis or, in some cases, by taking certain medications. The muscles of the pelvic floor in women are also weakened by pregnancy and childbirth. As a rule, this leads to a lack of control of the excretory organs, and in the worst case even to bladder prolapse, vaginal prolapse or even uterine prolapse. However, these weaknesses can be remedied by appropriate regression training. There are special exercises that help to develop and control the muscles of the pelvic floor in women and also help women to better control their orgasm. Women who tense the muscles of their pelvic floor or even the vagina reflexively or even permanently have a so-called vaginal spasm or vaginismus. These women are usually unable to relax the corresponding muscles during a gynecological examination or during sexual intercourse in such a way that pain-free penetration of the speculum or penis is possible. In the medical field, a so-called hernia (hernia in which viscera emerge from the abdominal cavity through a congenital or acquired gap) in the area of the pelvic floor with a possible protrusion perineum is a perineal hernia. This condition rarely occurs in humans, but is common in male domestic dogs that have not been neutered. In perineal hernia, there is usually a hernia between sphincter ani externus muscle (exit orifice of the intestine) and levator ani muscle (siphon of the anus) or between levator ani muscle and coccygeus muscle (muscle of the coccyx). As a preventive measure against impairment of the muscles of the pelvic floor, care should be taken to maintain a healthy body weight.In addition, it is useful to strive for good posture and also to avoid physically heavy load. After pregnancy and childbirth, women should definitely take part in a course of postnatal gymnastics to avoid later consequences as much as possible.
