Spinal control of pelvic floor muscles

A prevalent notion in the literature is that the pelvic floor muscles behave as a unitary mass. We examined this proposition experimentally. In spinal cats, we recorded EMG activity from the following pelvic floor muscles: the sphincter ani externus (SAE), the abductor caudae internus (coccygeus), and the levator ani (pubiocaudalis) muscles. The epaxial sacrocaudalis dorsalis lateralis muscle was also exposed and prepared for recording. Electrical stimulation of S2 ventral roots elicited twitch responses of the sphincter ani externus and of the sacrocaudalis dorsalis lateralis muscles. Stimulation of S3 and Cx1 ventral roots elicited responses in the other two muscles studied, the levator ani and abductor caudae internus. Thus a clear segregation of the segmental motor neuron pools innervating the different pelvic floor muscles was demonstrated. The various muscles of the pelvic floor region could be reflexly activated either individually or as a mass unit depending on the intensity of stimulation. Tactile or electrical stimulation of pudendal regions on either side of the body elicited responses of the sphincter ani externus. In contrast, activation of the levator ani and abductor caudae internus muscles could be lateralized: tactile or electrical stimulation of the dorsolateral surfaces at the base of the tail region elicited ipsilateral responses from these muscles. Section of one pudendal nerve did not alter the level of tonic activity (2 to 4/s) of the sphincter ani externus. However, bilateral section of the pudendal nerve entirely abolished both tonic activity and phasic responsiveness of the SAE without affecting the activity of the levator ani and abductor caudae internus muscles. Pudendal nerve stimulation elicited only polysynaptic reflex responses from S2 ventral roots. The results presented show that the neural apparatus of the striated musculature of the pelvic floor is capable of activating individually the different muscles that make up the system, and that the sphincter ani externus from one side, and muscles that conform the diaphragm pelvis from the other, are subserved by different neuronal circuits.