Contraction of the pelvic floor muscles during abdominal maneuvers

https://www.gynecologiconcology-online.net/article/S0090-8258(00)96010-4/pdf

Class II versus class III radical hysterectomy in stage IB-IIA cervical cancer: a prospective randomized study.

Aims Due to their contribution to modulation of intra-abdominal pressure (IAP) and stiffness of the sacroiliac joints, the pelvic floor muscles (PFM) have been argued to provide a contribution to control of the lumbar spine and pelvis. Furthermore, as IAP is modulated during respiration this is likely to be accompanied by changes in PFM activity. Methods In order to evaluate the postural and respiratory function of the PFM, recordings of anal and vaginal electromyographic activity (EMG) were made with surface electrodes during single and repetitive arm movements that challenge the stability of the spine. EMG recordings were also made during respiratory tasks: quiet breathing and breathing with increased dead-space to induce hypercapnoea. Results EMG activity of the PFM was increased in advance of deltoid muscle activity as a component of the pre-programmed anticipatory postural activity. This activity was independent of the direction of arm movement. During repetitive movements, PFM EMG was tonic with phasic bursts at the frequency of arm movement. This activity was related to the peak acceleration of the arm, and therefore the amplitude of the reactive forces imposed on the spine. Respiratory activity was observed for the anal and vaginal EMG and was primarily expiratory. When subjects moved the arm repetitively while breathing, PFM EMG was primarily modulated in association with arm movement with little respiratory modulation. Conclusions This study provides evidence that the PFM contribute to both postural and respiratory functions.

https://pudendalnerve.com.au/website/wp-content/uploads/2013/05/art0150.pdf

Postural and respiratory functions of the pelvic floor muscles.

Ultrasound imaging is rapidly replacing radiological methods in the investigation of pelvic floor disorders. Transrectal, transvaginal/introital and transperineal/translabial methods are being employed, with the latter probably the most widespread due to ease of use and availability of equipment. Position and mobility of the bladder neck, bladder wall thickness, pelvic floor muscle activity and uterovaginal prolapse can be quantified, and color Doppler may be used to document stress urinary incontinence. Ultrasound imaging has simplified audit activities and enhanced our understanding of the effects of incontinence and prolapse surgery, such as the new synthetic suburethral slings. In recent years, imaging methods have contributed significantly to our understanding of the traumatic effects of childbirth on the pelvic floor. Finally, the assessment of pelvic floor biomechanics may have implications for clinical obstetrics and ultimately for the prevention of delivery-related pelvic floor trauma.

https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1002/uog.939

Ultrasound imaging of the pelvic floor. Part I: two-dimensional aspects

Treatment outcome after varicocelectomy. A critical analysis.

Anatomical and functional changes in the lower urinary tract during pregnancy.

Prognostic-significance of single versus multiple lymph-node metastases in cervical-carcinoma stage ib

Factors related to semen improvement and fertility after varicocele operation

Anatomical and functional changes in the lower urinary tract following spontaneous vaginal delivery

With a curved array real-time ultrasound scanning machine and the probe placed sagitally onto the vulva, symphysis, bladder, urethra and the pelvic floor can be visualized in one frame. With this technique we studied 10 women with stress incontinence and 10 control women. In both groups active contraction of the pelvic floor resulted in a similar elevation of the urethrovesical junction (UVJ). During Valsalva maneuver an equal descent of the UVJ was found in patients and controls. During coughing a significant descent of the UVJ only occurred in the patient group. This suggests that women with stress incontinence are capable of operating the pelvic floor muscles but do not use them adequately during a cough.

Dick J. Tinga

Papers

Anatomical and functional changes in the lower urinary tract during pregnancy.

Prognostic-significance of single versus multiple lymph-node metastases in cervical-carcinoma stage ib

Factors related to semen improvement and fertility after varicocele operation

Anatomical and functional changes in the lower urinary tract following spontaneous vaginal delivery

Perineal ultrasonography in women with stress incontinence and controls: the role of the pelvic floor muscles.