Gynecological problems relevant to coloproctology

Abstract

During the embryonic period the urorectal septum divides the cloaca into an anterior urogenital sinus, which will eventually become the bladder and urethra, and a posterior anorectum. Pelvic organs therefore share a common origin and assume a similar role: as a reservoir allowing storage and the timely evacuation of urine or feces, thus maintaining continence. Pelvic organs also have a common support complex, the pelvic floor, which is made of muscles and fasciae. The pelvic organ physiology and nerve supply are also very similar. In women, the middle compartment is occupied by the vagina and uterus, the former contributing to pelvic organ support through its close connections to the pelvic sidewalls. Not surprisingly, functional and anatomical dysfunction of the different pelvic compartments frequently coexist. Urinary incontinence (UI) is present in 10-40% of patients consulting for fecal incontinence [14], and symptoms of anorectal incontinence are present in one-third of women consulting for UI. Pelvic organ prolapse also interferes with function by impairing either evacuation or continence. It is therefore of paramount importance for all specialists dealing with pelvic floor dysfunction to be aware of coexisting troubles in other pelvic compartments. © 2010 Springer-Verlag Berlin Heidelberg.