pelvic floor

Eva Rudolf-Müller is a freelance writer in the medical team. She studied human medicine and newspaper sciences and has repeatedly worked in both areas - as a doctor in the clinic, as a reviewer, and as a medical journalist for various specialist journals. She is currently working in online journalism, where a wide range of medicine is offered to everyone.

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The pelvic floor with its muscles is the lower end of the pelvis. It consists of three layers, which are composed of several muscles and connective tissue layers. The pelvic floor stabilizes the pelvic organs, which exert a downward pressure when people walk upright. However, due to the necessary openings for the intestines, urinary and sexual organs, it also has weak points. Read everything you need to know about the pelvic floor!

What is the pelvic floor?

The pelvic floor is the lower end of the small pelvis. It consists of three muscle layers that only have narrow openings for the intestines, the urinary and genital organs. From the inside out, these are: the pelvic diaphragm, the urogenital diaphragm and the outer sphincter layer. The three muscle layers are arranged like a fan on top of one another and are connected to one another at several points via muscle fibers and fasciae. In total, they are about four inches thick.

The strongest and largest of these three layers is the pelvic diaphragm, the inner, funnel-shaped layer of the pelvic floor. It consists of two muscles (levator ani muscle and coccygeus muscle). The pelvic diaphragm has a longitudinal gap (levator slit) for the urinary and sexual tract. In women, this is the weakest point in the pelvic floor.

The urogenital diaphragm is an approximately one centimeter thick, trapezoidal muscle plate that is covered on both sides by strong connective tissue. It extends from the pubic symphysis (symphysis) and the two pubic branches to the ischial tuberosities and partially covers the levator slit from below - however, it does not close the weak point. The urogenital diaphragm also has an opening for the urethra and (in women) the vagina. The fibers around the point of passage for the urethra form the external urethral sphincter (bladder sphincter). In women, some muscle fibers radiate into the vaginal wall.

The outer sphincter muscle layer (outer pelvic floor muscles) consists of several individual muscles. These include, above all, the erectile tissue muscle (musculus bulbocavernosus = M. bulbospongiosus) and the ring-shaped external anal sphincter muscle (M. sphincter ani externus). In women, these two form an eight-shaped muscle loop around the vagina and anal canal.

What is the function of the pelvic floor?

The pelvic floor holds the abdominal and above all the pelvic organs, which exert downward pressure when people walk upright. It also helps to block the intestines, urethra and vagina. When lifting heavy loads or strenuous physical exertion, high pressure is created in the abdomen, which the pelvic floor has to resist.

The pelvic diaphragm, as the strongest layer, lifts and closes the anus and is therefore important for stool continence. The urogenital diaphragm, on the other hand, is important for the occlusion of the urethra and thus urinary continence. The erectile tissue, which is part of the external pelvic floor muscles, narrows the entrance to the vagina when it is tense. In addition, it contracts rhythmically and involuntarily during a female orgasm and causes the clitoris to straighten up in a state of excitement. In men, this muscle supports urination and ejaculation.

Where is the pelvic floor located?

The pelvic floor is the muscular-connective tissue lower end of the small pelvis. It only leaves gaps for the intestines and the urinary and genital organs. There is a connection to the lumbar spine, the pelvic bones and the tailbone.

What problems can the pelvic floor cause?

Heavy physical labor, pregnancy, and childbirth can weaken the pelvic floor, which can lead to urinary incontinence and prolapse (prolapse) of the bladder or uterus. A tear in the perineum during childbirth can cause problems with the anus sphincter. In addition, benign and malignant tumors in the pelvic floor region are also possible.

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