Pelvic floor
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The pelvic floor or pelvic diaphragm is composed largely of muscle fibers of levator ani and connective tissue. It is important in providing support for pelvic organs, e.g. the bladder, lower intestines, the uterus (in females), and in maintenance of continence as part of the urinary and anal sphincters.
In women, the levator muscles can be weakened by damage or lost nerve input as from childbirth. Pelvic floor exercises (also known as Kegel exercises) can lead to development and improved control of the pelvic floor muscles. Improving the control of these muscles may also help women who suffer from urinary incontinence. The urethral sphincter is at least partially responsible for urinary continence in women but intact vaginal support and levator muscular tone also play an important role in female urinary continence. Lost neural support to either the urinary sphincter or levator ani or lost vaginal support can all contribute to an individual womans urinary incontinence problem.
Unfortunately, damage to the pelvic floor does not only contribute to urinary incontinence but pelvic organ prolapse as well. Pelvic organ prolapse occurs in women when pelvic organs (e.g. the vagina, bladder, rectum, or uterus) protrude into or outside of the vagina. The causes of pelvic organ prolapse are not unlike those that also contribute to urinary incontinence and are likely multifactorial. Age, childbirth, family history, hormones all likely contribute to the development of pelvic organ prolapse. The common perception that prolapse stems from lost "fascial" support is difficult to support in light of the available evidence. The vagina is suspended by attachments to the perineum, pelvic side wall and sacrum via attachments that include collagen, elastin, and smooth muscle. Repair of lost vaginal support may involve surgery.