[Case management of pelvic floor disorders]

Area of Science:

• Urogynecology and Pelvic Floor Medicine.
• Anatomy and Biomechanics of the Pelvic Floor.

Context:

• Pelvic floor disorders often involve multiple components and arise from an imbalance between intra-abdominal pressure and the pelvic floor's mooring forces.
• Mooring forces include visceral ligaments, endopelvic fascia, and pelvic muscles like the levator ani.

Purpose:

• To emphasize the necessity of a holistic approach to managing pelvic floor disorders.
• To detail the diagnostic utility of functional and anatomical physical examinations, supplemented by radiography or MRI when needed.
• To outline treatment considerations based on patient-specific factors and surgical expertise.

Summary:

• Pelvic floor disorders affect all three pelvic floor components, linked by an imbalance in forces.
• Diagnosis involves thorough physical examination (functional and anatomical) and imaging (colpocystography, defecography) if necessary.
• Treatment strategies must address dysfunctions, incontinence, and ptosis, tailored to patient age, anatomy, function, and surgeon experience.

Impact:

• Highlights the interconnected nature of pelvic floor disorders, advocating for comprehensive patient evaluation.
• Provides a framework for diagnostic approaches, including advanced imaging techniques.
• Underscores the individualized nature of treatment selection for optimal patient outcomes in pelvic floor dysfunction.