Introduction to the pelvic floor

March 10, 2025
1:20 pm

The pelvic floor is a set of muscles, fasciae and ligaments located in the lower part of the trunk, anchored to the pelvic bones, like a "hammock". Although for a long time it was thought that their only function was to support the pelvic viscera (bladder, uterus and rectum in women; bladder, prostate and rectum in men), it is now known that they perform many other tasks. They are involved in stabilising posture, balance and gait, as well as in breathing, through coordinated action with the abdominal muscles, especially the deep abdominal muscles, and the gluteal muscles. They also collaborate in the physiological functions of the pelvic organs, and in particular in the coordination of urination and defecation. In women, the pelvic floor also plays a very important role during sexual intercourse and childbirth. In men, it plays a role in erection and ejaculation.

The structure and function of the pelvic floor is very complex. To this day there is still a great discrepancy between authors, with various nomenclatures and theories regarding micturition and continence mechanisms. For this reason, I will not venture to give more general details on the subject, as it would take several hundred pages. I will focus on the role it plays in micturition, which is, from the point of view of urinary tract infections, what matters to us. But before I go into that, I would like to point out the difference between the terms "pelvic floor" and "perineum", because although they are often used interchangeably, they have a different meaning. The perineum is the anatomical region that closes the lower part of the pelvis, while the pelvic floor is a set of muscles, ligaments and fasciae, as I have already mentioned, located in the pelvis (and part of it, in the perineum). It is like imagining that the pelvic floor is the door of the house and the perineum is the façade of that house. The door is integrated into the façade, but the door is not the same as the façade. Therefore, the pelvic floor is not the same as the perineum. However, for practical purposes, these two terms are often used interchangeably, and on this website we will do so.

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