Putative protective effects of cesarean section on pelvic floor disorders

Pregnancy can affect the lower genitourinary tract through physiologic changes, or traumatic injury tissue stretching and tearing, besides neurologic and vascular compression and compromise, and muscle strain are inevitable during childbirth.The levator ani complex of the pubococcygeus, puborectalis, and iliococcygeus muscles must allow passage of the fetus. The perineal body and external anal sphincter may become injured, with or without episiotomy, but sometimes as a necessary maneuver to allow passage of the fetal head or shoulders. The traumatic insults may lead to permanent damage on pelvic floor and subsequent urinary or anal incontinence.In this article we aim to review the literature regarding the impact of pregnancy or childbirth on pelvic floor changes.