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]]The pelvic floor or pelvic diaphragm is an anatomical location in the human body which has an important role in urinary and anal continence, sexual function, and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and smooth, ligaments, and fascia and separates between the from above, and the from below. It is formed by the and , and associated connective tissue.

The pelvic floor has two hiatuses (gaps): (anteriorly) the urogenital hiatus through which and pass, and (posteriorly) the rectal hiatus through which the passes.

(2025). 9788131225561, Elsevier.


Structure

Definition
Some sources do not consider "pelvic floor" and "pelvic diaphragm" to be identical, with the "diaphragm" consisting of only the levator ani and coccygeus, while the "floor" also includes the perineal membrane and deep perineal pouch.
(2025). 9780443066122, Elsevier Health Sciences TW.
However, other sources include the as part of the diaphragm. In practice, the two terms are often used interchangeably.


Relations
The of the has the pelvic floor as its inferior boundary (and the as its superior boundary). The has the pelvic floor as its superior boundary.

Posteriorly, the pelvic floor extends into the .


Function
It is important in providing support for pelvic (organs), e.g. the , , the (in females), and in maintenance of as part of the urinary and sphincters. It facilitates birth by resisting the descent of the presenting part, causing the fetus to rotate forwards to navigate through the pelvic girdle. It helps maintain optimal intra-abdominal pressure.


Clinical significance
]]The pelvic floor is subject to clinically relevant changes that can result in:

Pelvic floor dysfunction can result after treatment for gynecological cancers.

Damage to the pelvic floor not only contributes to urinary incontinence but can lead to pelvic organ . 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. These include inappropriate (asymmetrical, excessive, insufficient) muscle tone and asymmetries caused by trauma to the pelvis. Age, pregnancy, family history, and hormonal status all contribute to the development of pelvic organ prolapse. The vagina is suspended by attachments to the perineum, pelvic side wall and sacrum via attachments that include collagen, elastin, and smooth muscle. Surgery can be performed to repair pelvic floor muscles. The pelvic floor muscles can be strengthened with .

Disorders of the posterior pelvic floor include , , , and a number of functional disorders including . due to any of these disorders is called "functional constipation" and is identifiable by clinical diagnostic criteria. Pelvic floor exercise (PFE), also known as , may improve the tone and function of the pelvic floor muscles, which is of particular benefit for women (and less commonly men) who experience stress urinary incontinence. However, compliance with PFE programs often is poor, PFE generally is ineffective for urinary incontinence unless performed with and trained supervision, and in severe cases it may have no benefit. Pelvic floor muscle tone may be estimated using a , which measures the pressure within the vagina. Medication may also be used to improve continence. In severe cases, surgery may be used to repair or even to reconstruct the pelvic floor. One surgery which interrupts pelvic floor musculature in males is a radical prostatectomy. With the removal of the , many males experience urinary incontinence post operation; pelvic floor exercises may be used to counteract this pre and post operation. Pre-operative pelvic floor exercising significantly decreases the prevalence of urinary incontinence post radical prostatectomy. Prostatitis and prostatectomies are two contributors to erectile dysfunction; following a radical prostatectomy studies show that erectile dysfunction is improved by pelvic floor muscle training under the supervision of physical therapists certified in pelvic floor rehabilitation .

or pelviperineology is a specialty dealing with the functional troubles of the three axes (urological, gynecological and coloproctological) of the pelvic floor.

== Additional images ==


See also
  • (tailbone)
  • Female genital prolapse
  • Pelvic floor dysfunction
  • Pubococcygeus muscle
  • Vaginal support structures
  • Vesicovaginal fistula


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