Anonymous Musings: June 22, 2017


Description Of Anatomy And Function [Dysfunction]


The pelvic floor is slung like a hammock at the base of the pelvis. It is a complex area of the human body composed of many nerve and nerve endings [the pudendal nerve is the main nerve in the pelvic region], fascia, soft tissue, cartilage, ligaments, bone, blood vesicles, and various muscle fibers. It forms a muscular partition which separates the pelvic cavity above, to the perineal region below.

The three main structures that make up the pelvic floor are the pelvic diaphragm, the perineal membrane and the deep perineal pouch. The pelvic diaphragm consists of three sets of fibers that make up the levator ani muscle. These muscles sit like a horizontal foundation in the pelvic floor forming its base. The muscles include the left and right pubococcygeus, iliococcygeus, and also the puborectalis which wraps around the anus muscle.

The urogenital hiatus is the gap structure [or lack of it] in these base muscles that allows the passage of the urethra, the rectal canal, the vas deferens [in men], and vaginal canal [in women] through the pelvic floor basin. Thick fascia attaches the levator ani muscles to the left and right obturator internus and piriformis muscles which sit somewhat vertically in the pelvic to form part of the pelvic floor walls. The left and right iliacus muscles, which sit on the internal side of the hip bone, further strengthen the pelvic floor walls.

The pelvic floor sits as the soft tissue foundation to the pelvic structure and is no bigger than a cantaloupe which has been cut in half. If one were to scoop out the fruit of the melon, the remaining structure would resemble the configuration of the pelvic floor basin.

As well as holding up all of the human organs into the abdomen, including the bladder, intestines, the prostate in males [the prostate is a walnut-sized organ below the male bladder that surrounds the urethra and contributes fluid to the semen] and the uterus in females, the pelvic floor muscles, genitalia muscles and various sphincter muscles work in unison with the brain when we urinate, defecate and orgasm [ejaculate].

A complex and timely interaction of muscles and neurological messages occurs in the pelvic floor in a similar way as a multi road intersection and railway crossing would function and operate in peak hour traffic. Everything has its turn and everything gets to where it wants to go.

With urination for example, the bladder and the pelvic floor work in synchrony – when urination starts, the muscles in the pelvic floor are relaxed, and the smooth muscle in the wall of the bladder contracts. When urination stops, the pelvic floor contracts, and the muscles in the bladder relax.

It is acknowledged that a person suffering with Chronic Pelvic Pain will have a pelvic floor muscle profile which is taut like a trampoline, rather than loose like a hammock. The tension in the floor muscles causes the surrounding muscles and anatomy to be compromised in terms of normal position and behavior. The pain and dysfunction is a direct result of the heightened and tightened posture of the pelvic floor muscles and the constricting of the pelvic wall muscles.

The urethral, rectal and vaginal canals can become compromised via the upward compression of the muscles literally strangling [entrapping] their pathway down and through the pelvic floor basin. A more common example of this type of situation is forming a kink in a garden hose to either stop or slow the flow of water without turning the tap as regulator.

The compression caused by the raising of the pelvic floor due to this tension, has a multitude of differing and adverse effects on the sufferer:-

Firstly, pain becomes a constant, simply explained by the compacting of the insides into a space which is neither natural nor functional.

Secondly, pain and dysfunction occurs in the processes of:-
Urination [Dysuria]
Defecation [Tenesmus]
Sex and Orgasm [Dyspareunia]

The third aspect is the emotional and psychological trauma a sufferer has to contend with, and last but not least, is the disruption it causes on sleep.

The anxiety developed by the pain and dysfunction subsequently feeds into the cycle of tension, which further promotes the pelvic floor to sit taut and compress the organs. A vicious cycle develops and the sufferer is caught up in the sting, with an on-going presence which does not subside, but rather, continues on unabated if allowed.

A sufferer can also feel that their discretion and dignity becomes compromised as a result of the symptoms and the location of the pain. The sufferer’s self-esteem is eroded. The whole issue can become overwhelming, and this feeling of helplessness and embarrassment is a further anxiety feeder into the impenetrable cycle which keeps the whole manifestation going.

Discussing the pain and dysfunction is not easy. One’s lack of understanding as to what is happening feeds into the taboo of the whole situation. The entire subject becomes a confronting issue and ratification is often unavailable even to those that try desperately to seek it.

There is further indignity in that rudimentary pleasures of life are stripped from a sufferer as if to rub salt into their already heightened torment. Urination, defecation and indeed orgasm [ejaculation] can become so painful and so maligned that these simple pleasures of life are genuinely avoided, at least minimized, to prevent the hideous pain associated with their occurrence compounding the person suffering.



This story details the life journey of one individual and is not intended to be a substitute for competent medical advice and or professional treatment.
Some of the medical information contained in this story is not the original work of the author. As best as possible, original sources and web sites have been credited and referenced.
Other than the personal account, this story has been adapted from information which is freely available to the general public.