Review article| Volume 265, P143-149, October 2021

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Pelvic-floor function, dysfunction, and treatment


      The pelvic floor functions as a holistic entity. The organs, bladder, bowel, smooth and striated muscles, nerves, ligaments and other connective tissues are directed cortically and reflexly from various levels of the nervous system. Such holistic integration is essential for the system’s multiple functions, for example, pelvic girdle stability, continence, voiding/defecation, and sexuality. Pelvic floor dysfunction (PFD) is related to a variety of pelvic pain syndromes and organ problems of continence and evacuation. Prior to treatment, it is necessary to understand which part(s) of the system may be causing the dysfunction (s) of Chronic Pelvic Pain Syndrome (CPPS), pelvic girdle pain, sexual problems, Lower Urinary Tract Symptoms (LUTS), dysfunctional voiding, constipation, prolapse and incontinence. The interpretation of pelvic floor biomechanics is complex and involves multiple theories. Non-surgical treatment of PFD requires correct diagnosis and correctly supervised pelvic floor training.
      The aims of this review are to analyze pelvic function and dysfunction. Because it is a holistic and entirely anatomically based system, we have accorded significant weight to the Integral Theory’s explanations of function and dysfunction.



      A fibers (alpha nerve fibers are myelinated and carry information related to proprioception), ATFP (arcus tendineus fascia pelvis), BPS/IC (bladder pain syndrome), CGRP (calcitonin-gene related peptide), CL (cardinal ligament), C (nerve fibers are unmyelinated. They carry information related to pain, temperature and itch), CPPS (chronic pelvic pain syndrome), EAS (external anal sphincter), EUL (external urethral ligament), IBS (irritable bowel syndrome), IT (integral theory (IT)), LUTS (lower urinary tract symptoms), n (nerve), N (bladder stretch receptors), OAB (overactive bladder), PB (perineal body), PCF (pubocervical fascia), PF (pelvic floor), PFD (pelvic floor dysfunction), PFM (pelvic floor muscle(s)), PFS (posterior fornix syndrome), PUL (pubourethral ligament), RVF (rectovaginal fascia), USL (uterosacral ligaments), WDR (wide dynamic range)
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