Pelvic Floor Disorders: Epidemiology and Pathophysiology and New Treatment Options

Pelvic Floor Disorders: Epidemiology and Pathophysiology and New Treatment Options

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Sarah de la Torre, MD and Jeff Muir, MD

The female pelvic floor is composed of the musculature, soft tissues, and connective tissues providing structural support for the bowel, bladder, uterus, and other pelvic organs. Disorders affecting one or more of these organs, broadly referred to as pelvic floor disorders(PFDs), are a common occurrence following pregnancy, childbirth—in particular vaginal deliveries—and menopause. The weakening of the pelvic floor or relaxation of the vaginal muscles, also referred to as vaginal relaxation syndrome (VRS), is one of the most common PFDs. VRS causes a loss of voluntary muscle control and decreased vaginal sensation, impacting urinary control and sexual function. Distention of the vaginal wall musculature leads to a cascade of cellular changes that ultimately weaken impact protein and collagen metabolism, thus resulting in patient morbidity. Another common consequence associated with aging, especially after menopause, is vaginal atrophy (VA), when estrogen deprivation accelerates the process of deterioration of vaginal tissue, leading to vaginal dryness and irritation, among other conditions. While the health implications of these problems are significant, they also negatively impacts self-esteem and quality of life for women.

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