Pathophysiology of the pelvic floor: Basic physiology, effects of ageing, and menopausal changes

Abstract

The etiologic risk factors and associations contributing to pelvic floor disorders include vaginal parity, ageing, hormonal status, pelvic surgery, collagen diseases, and depression. Many of these relationships, including hormonal status, are poorly understood. In addition, not all pelvic floor disorders are explained by the same risk factors or mechanisms. For example, vaginal parity appears to be the greatest risk factor for developing pelvic organ prolapse, while urinary incontinence has many other risks factors with equal or greater influence, including obesity and ageing. The basic mechanisms of disease and structural failure, both gross and microscopic, which lead to pelvic floor disorders need further investigation. A better understanding of the muscular, collagen, and neuronal components of the pelvic organs and their supports would provide targeted areas for prevention and treatment. © 2010 Springer-Verlag Milan.