Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy.
Maturitas. 2013 Nov;76(3):230-4. doi: 10.1016/j.maturitas.2013.08.008. Epub 2013 Sep 6.
Female pelvic floor is a complex functional unit involved in multiple functions that extend beyond the sole support of pelvic organs. Pelvic floor dysfunction globally affects micturition, defecation and sexual activity. Evolutionary modifications such ad adaptation to upright standing, walking and the need to deliver fetuses with larger head diameters made the fascial and muscle support of the pelvic floor vulnerable, therefore predisposing women to pelvic organ prolapse and incontinence. Different than in males, the female pelvic floor undergoes a number of adaptive changes related to life and endocrine events. Most of the clinical manifestations of these changes become apparent after menopause and throughout aging in women. This review article summarizes the key aspects of the pathophysiology and the clinics of the modifications of the pelvic floor in women through midlife and beyond. A particular focus is given to the relationship between urinary and bowel dysfunction.
女性盆底是一个复杂的功能单位，涉及多种功能，不仅仅是单纯地支撑盆腔器官。全球范围内，盆底功能障碍会影响排尿、排便和性生活。为适应直立行走和分娩更大头围胎儿的需要，女性在进化过程中发生了适应性改变，导致盆底筋膜和肌肉的支持结构变得脆弱，从而使女性容易发生盆腔器官脱垂和尿失禁。与男性不同，女性盆底会经历与生命和内分泌事件相关的一系列适应性改变。这些改变的大部分临床表现会在女性绝经后和整个衰老过程中显现出来。本文综述了从中年到老年女性盆底的病理生理学和临床改变的关键方面，特别关注了尿便功能障碍之间的关系。
