The Role of the Levator Ani Muscle in Evacuation, Sexual Performance and Pelvic Floor Disorders

@article{Shafik2000TheRO,
  title={The Role of the Levator Ani Muscle in Evacuation, Sexual Performance and Pelvic Floor Disorders},
  author={Ahmed O. Shafik},
  journal={International Urogynecology Journal},
  year={2000},
  volume={11},
  pages={361-376}
}
  • A. Shafik
  • Published 1 November 2000
  • Medicine
  • International Urogynecology Journal
This paper reviews the role of the levator ani muscle (LAM) in evacuation, sexual performance and pelvic floor disorders. The LAM fixes the vesical neck, anorectal junction and vaginal fornices to the side wall of the pelvis by means of the suspensory sling and hiatal ligament. On contraction it shares in the mechanism of evacuation (urination, defecation). During the sexual act vaginal distension by the erect penis evokes the vaginolevator and vaginopuborectalis reflexes, with a resulting LAM… 
Pelvic floor and sexual male dysfunction.
TLDR
It is possible to imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life.
Role of the Perineal Muscles in Micturition
TLDR
Perineal muscles’ contraction at micturition presumably supports perineal floor and protects perineAL muscles from the high pressure induced by straining.
Study of the Effect of Straining on the Bulbocavernosus Muscle with Evidence of a Straining–Bulbocavernosus Reflex and its Clinical Significance
TLDR
It is hypothesized that this reflex is evoked by straining and results in BCM contraction and closure of the vaginal introitus, and is suggested to share in the prevention of rectocele.
THIS ARTICLE HAS BEEN RETRACTED. Physical therapy for premature ejaculation, erectile dysfunction and chronic pelvic pain syndrome.
TLDR
Physical therapists have a potential role as integral members of healthcare teams involved in the improvement of male sexual health and further research validating specific physical therapies in the assessment and treatment of maleSexual function is necessary.
The Use of HIFEM Technology in the Treatment of Pelvic Floor Muscles as a Cause of Female Sexual Dysfunction: A Multi-Center Pilot Study
TLDR
The initial experience shows that HIFEM technology is a promising method in addressing women’s decreased sexual satisfaction through the strengthening of PFM.
Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: a literature review.
  • T. Rosenbaum
  • Medicine, Psychology
    The journal of sexual medicine
  • 2007
TLDR
It has been proposed that the pelvic floor muscles are active in both male and female genital arousal and orgasm, and that pelvic floor muscle hypotonus may impact negatively on these phases of function.
"Diagnostic investigation of the pelvic floor": a helpful tool in the approach in patients with complaints of micturition, defecation, and/or sexual dysfunction.
INTRODUCTION Pelvic floor dysfunction is recognized to be related to lower urinary tract dysfunction and to lower gastrointestinal symptoms, and is an influential factor in dysfunction and subsequent
Effect of radiofrequency and pelvic floor muscle training in the treatment of women with vaginal laxity: A study protocol
TLDR
A study protocol to compare the effect of radiofrequency and pelvic floor muscle training in the treatment of women with complaints of vaginal laxity and expects the results of this randomized clinical trial to have a positive impact on the participants’ quality of life.
...
...

References

SHOWING 1-10 OF 68 REFERENCES
New concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. II. Anatomy of the levator ani muscle with special reference to puborectalis.
TLDR
The puborectalis and the deep external anal sphincter were found to be fused together and identical from the morphologic, histologic, and functional points of view as well as with respect to innervation.
Pelvic double-sphincter control complex. Theory of pelvic organ continence with clinical application.
A double-sphincter mechanism controlling the continence of pelvic organs is presented with a role-description of the involved pelvic musculature. The rectum and the urinary bladder identically have a
Pudendal canal decompression in the treatment of erectile dysfunction.
TLDR
It is suggested that chronic straining at stool in patients with neurogenic erectile dysfunction led to levator subluxation and sagging, and to pulling on the pudendal nerve with a resulting entrapment in the pUDendal canal, pudendedal neuropathy, and PCS, which improves with pudendsal canal decompression.
Role of pudendal canal syndrome in the etiology of fecal incontinence in rectal prolapse.
TLDR
Pudendal canal syndrome is suggested to play a significant role in the genesis of FI in CRP, and the constant prolongation of PNTML in patients with FI postulates a relationship between the two.
Stress urinary incontinence.
TLDR
The mechanism of continence is imperfectly understood, as is the precise mode of its cure, whether conservative or surgical, and the role of urethral resistance is hampered by lack of suitable techniques for measuring Urethral and sphincteric function.
Pudendal canal syndrome as a cause of vulvodynia and its treatment by pudendal nerve decompression.
  • A. Shafik
  • Medicine
    European journal of obstetrics, gynecology, and reproductive biology
  • 1998
A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation
  • A. Shafik
  • Medicine
    Diseases of the colon and rectum
  • 1980
TLDR
A “single loop continence” theory is presented, based on the fact that each of the three loops of the external sphincter has its own innervation, attachment, and direction of muscle bundles; each loop thus acts as a separate spHincter.
...
...