A new concept of pelvic floor support function: Striated–smooth muscle complex

Abstract

Pelvic floor and perineum muscles play an important role in the formation of an apparatus supporting pelvic organs. The functional insufficiency of myofascial structures frequently leads to the development of urinary and fecal incontinence, erectile dysfunction, prolapse of internal organs, and perineal hernias formation. Back in the 20th century, morphologists focused on the skeletal muscles in pelvic floor and perineum, highlighting their leading role in supporting organs and creating intraabdominal pressure. However, in the past two decades, particular attention has been paid to the smooth muscle structures and their relationship with the musculoskeletal system in the pelvic outlet area. The new concept of the striated–smooth muscle complex provides the basis for revising various aspects of pelvic organ prolapse and urinary and fecal incontinence pathophysiology. We believe that this may lead to improved early diagnosis and prevention of diseases of the pelvic floor and perineum.