Disfunzioni del pavimento pelvico e prolasso genito-urinario

[Autom. eng. transl.] NOTES ON THE FUNCTIONAL ANATOMY OF THE PELVIC FLOOR The pelvic floor is made up of a set of muscular and fascial structures that close the female pelvic excavation inferiorly, support the pelvic organs (bladder, vagina, uterus, rectum) and intervene in the mechanisms of urinary and fecal continence , in sexual activity and childbirth. The statics and dynamics of the pelvic organs are conditioned by two systems. - a suspension system made up in front of the pubo-vesico-uterine ligaments and the round ligaments, at the back by the uterine-sacral ligaments, and laterally by the cardinal ligament of Mackenrodt. This system connects the pelvic viscera to the wall of the pelvis itself and to the endopelvic fascia. - a support system, made up of a complex of striated muscles and connective tissue (endopelvic fascia). Proceeding from the inside towards the outside, this system is represented: 1) by the pelvic diaphragm, made up of the levator ani muscle (with its puborectalis, ileococcygeal, pubococcygeal and ischiococcygeal components) and the endo-pelvic fascia that covers it above and below; 2) from the urogenital diaphragm, located inferior to the pelvic diaphragm, represented by a musculoaponeurotic plate including the pubo-urethral and uteropelvic ligaments and the deep transverse muscle of the perineum; 3) from the plane of the superficial muscles of the perineum (plane of the sphincters) consisting of the bulbocavernosus muscle, the ischiocavernosus muscle and the superficial transversus ani.