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Pelvic Floor Muscle Dysfunction: A Review

Finamore, Peter S. MD, MA*; Goldstein, Howard B. DO, MPH*; Whitmore, Kristene E. MD

Journal of Pelvic Medicine and Surgery: November-December 2008 - Volume 14 - Issue 6 - p 417-422
doi: 10.1097/SPV.0b013e3181907870
Fellows Lecture Series

Pelvic floor muscle dysfunction is a problem that affects women of all ages. The disorder can present as chronic pelvic pain, dyspareunia, rectal pain, chronic constipation, lower back pain, and a wide array of other complaints. As a result of the various presenting symptoms, patients with pelvic floor muscle dysfunction are seen by a variety of health care workers, including obstetrician-gynecologists, urogynecologists, urologists, colorectal surgeons, orthopedic surgeons, physical therapists, chiropractors, pain management specialists, psychotherapists, and others. The purpose of this review is to discuss the etiology, symptomatology, associated conditions, diagnostic tools, and treatment options for this condition.

The supportive function of the female pelvic floor is generally achieved by a combination of multiple components working together in a highly coordinated, specialized fashion. This intricate unit is made up of bones, ligaments, muscles, connective tissue, visceral organs, nerves, and vessels. These components are involved in a wide variety of functions that range from simple acts, such as sitting, standing, and walking to more complicated ones, such as child birth, micturition, and defecation. The dynamic capacity of the pelvic floor can be traumatized by a number of events and this can lead to pelvic floor dysfunction. It is important to review the anatomy and function of the pelvic floor, and recognize potential causes for damage and options for treatment when there is dysfunction.

Pelvic floor muscle dysfunction is a condition that can exist on its own or in association with other conditions. It is frequently unrecognized because many health care providers are not specifically looking for it as a potential cause for patient complaints. Treatment usually involves a multidisciplinary approach.

From the *Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Cooper University Hospital, Camden, New Jersey, and †Division of Female Pelvic Medicine and Reconstructive Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.

Reprints: Peter Simon Finamore, MA, MD, 6012 Piazza at Main St, Voorhees, NJ 08043. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.