China
Africa
Explore chapters and articles related to this topic
Trunk Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Rowan Sherwood
Levator ani forms a large part of the pelvic floor and is comprised of small muscles that are not easily differentiated (Standring 2016). The muscles that comprise levator ani vary considerably between individuals, and these muscles are described differently by different researchers (Bergman et al. 1988). Levator ani is typically described as being comprised of iliococcygeus, pubococcygeus, and puborectalis, though some include ischiococcygeus (coccygeus, see the entry above) as part of the levator ani (Standring 2016), or puborectalis as part of pubococcygeus (Standring 2016).
Hip Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
There are a number of soft tissues inserted in the coccyx. Levator ani at the apex is a group of three muscles including the pubococcygeus, the iliococcygeus, and the puborectalis. Levator ani forms the greater part of the pelvic floor.67 The coccygeus muscle arises from the ischium across the anterior aspect of the coccyx and the gluteus maximus across the posterior aspect.
Biofeedback, Relaxation Training, and Cognitive Behavior Modification
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Ann L. Davidoff, William E. Whitehead
Proctalgia fugax is an idiopathic disorder characterized by recurring attacks of fleeting, intense anorectal pain. These attacks occur at irregular intervals—typically less than six times per year—and last several seconds to 20 minutes before ending (44). Some authors consider the disorder a variant of levator ani syndrome (45). Common precipitators are flatus or defecation for roughly a third of patients and sexual intercourse for 6% (45). Prevalence rates of 13.6% (2) to 18.4% (46) have been reported in healthy adults. The condition is approximately twice as common in females as in males, according to one survey (2) and is rarely reported before puberty (45). Among 148 clinic patients presenting with GI complaints, a 33% prevalence was found, with women outnumbering men by more than three times (51% to 12%) (47).
Restoration of bladder neck activity and levator hiatus dimensions in Asian primipara: a prospective study
Published in Journal of Obstetrics and Gynaecology, 2023
Zexuan Yang, Liuying Zhou, Liwen Yang, Hui He
The female pelvic floor is composed of pelvic organs with multiple layers of supporting tissues such as the levator ani muscle and fascia. These supporting tissues act as a "hammock" holding the pelvic organs including the bladder, uterus, and rectum. Disorder of these supporting tissues results in pelvic floor dysfunction (PFD). The most common symptoms of PFD include pelvic organ prolapse and stress urinary incontinence. Vaginal delivery is the primary risk factor for PFD (Dietz 2006, Blomquist et al.2018). Both the levator hiatus dimension (a parameter associated with pelvic organs prolapse (Shek et al.2012, Staer-Jensen et al.2013, van Veelen et al.2014b) and bladder neck descent (BND) (a parameter related to stress urinary incontinence (Staer-Jensen et al.2015, van Veelen et al.2014a, de Araujo et al.2018, Reimers et al.2019) are increased postpartum.
Medium-term outcomes 2 years after laparoscopic sacrocolpopexy: a retrospective cohort study in Japan
Published in Journal of Obstetrics and Gynaecology, 2022
Hirotaka Sato, Shota Otsuka, Hirokazu Abe, Sachiyuki Tsukada
Surgeries were performed at Hokusuikai-Kinen Hospital by a trained urologist. Briefly, two pieces of polypropylene mesh (GYNEMESH PS; Ethicon, Somerville, NJ) were used for LSC. In patients with a uterus, supracervical hysterectomy was typically performed. When uterus preservation was required, the anterior mesh strip was Y-shaped and penetrated through the broad ligament. Then, posterior dissection of the levator ani muscles was performed bilaterally, and posterior mesh was fixed to the levator ani muscles using non-absorbable sutures (Tefdesser II; Kono Seisakusyo, Chiba, Japan). Anterior dissection of the bladder neck was performed. The anterior mesh was fixed to the vaginal wall using non-absorbable sutures, and the anterior and posterior mesh pieces were then sutured together bilaterally to the cervical stump and uterosacral ligaments using non-absorbable sutures. Subsequently, the peritonea overlying the sacrum were dissected. The parietal end of one piece of mesh was then fixed to the sacral promontory using non-absorbable sutures. Peritoneal closure was performed above the mesh pieces using absorbable sutures (Monocryl; Ethicon). All reoperations for SUI were performed with a tension-free vaginal tape obturator (TVT-O).
Pelvic floor dysfunction in midlife women
Published in Climacteric, 2019
Pelvic floor integrity is maintained by the coordinated actions of muscles (levator ani, urethral and anal sphincters), nerves (sacral plexus and pudendal nerve), and connective tissue (endopelvic ‘fascia’, perineal body, uterosacral and cardinal ‘ligaments’) anchored to the bony pelvis. The levator ani muscles close the urogenital hiatus, providing support by preventing protrusion of organs through that aperture. The fused posterior component of the muscles (the levator plate) offers a hammock-like support for the pelvic organs, preventing stretch and tension on the supportive connective tissue10. Endopelvic connective tissue provides additional visceral support, and is particularly important in maintaining it when the levators are weak. In the context of levator weakness, chronic tension can lead to fascial attenuation and structural failure. The levator ani muscles and endopelvic connective tissue therefore work together to provide normal pelvic support and urinary continence11. The quality of both muscle and collagen is integral to its ability to provide this dynamic support. Blood flow is essential for fibromuscular and neuromuscular tissue health, and vascularity is compromised by estrogen deficiency. It seems logical to conclude that menopause would negatively affect the pelvic floor and lead to dysfunction, especially over time and especially in the context of overall tissue aging.