Abstract

The pelvic floor is a muscular structure, pierced by the urethra, vagina and rectum. Upright posture has played a key role in its evolution. Oestrogen and progesterone receptors are present throughout the pelvic floor. Pelvic floor dysfunction is extremely common affecting at least one third of women during their lifetime. The major aetiological factor in pelvic floor dysfunction is vaginal delivery, but conditions associated with increased intra-abdominal pressure, obesity, smoking, pelvic surgery and high impact exercise are also involved. Oestrogen lack has marked effects on the urethra and anal sphincter. Normal function can thus be replaced by dysfunctions of several kinds of which urinary and anal incontinence and pelvic organ prolapse will be discussed.

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