The “pelvic floor” is the group of muscles that form a sling or hammock across the floor of the pelvis. Together with surrounding tissues, these muscles hold the pelvic organs in place so they can function correctly. The pelvic organs include the bladder, urethra, intestines, and rectum. A woman’s pelvic organs also include the uterus, cervix, and vagina.

The pelvic floor is a muscular sheet that defines the inferior portion of the pelvic cavity. The pelvic diaphragm, spanning anteriorly to posteriorly from the pubis to the coccyx, comprises the levator ani and the ischiococcygeus. Its openings include the anal canal and urethra, and the vagina in women.

The large levator ani consists of two skeletal muscles, the pubococcygeus and the iliococcygeus (image). The levator ani is considered the most important muscle of the pelvic floor because it supports the pelvic viscera. It resists the pressure produced by contraction of the abdominal muscles so that the pressure is applied to the colon to aid in defecation and to the uterus to aid in childbirth (assisted by the ischiococcygeus, which pulls the coccyx anteriorly). This muscle also creates skeletal muscle sphincters at the urethra and anus.

The perineum is the diamond-shaped space between the pubic symphysis (anteriorly), the coccyx (posteriorly), and the ischial tuberosities (laterally), lying just inferior to the pelvic diaphragm (levator ani and coccygeus). Divided transversely into triangles, the anterior is the urogenital triangle, which includes the external genitals. The posterior is the anal triangle, which contains the anus (image). The perineum is also divided into superficial and deep layers with some of the muscles common to men and women (image). Women also have the compressor urethrae and the sphincter urethrovaginalis, which function to close the vagina. In men, there is the deep transverse perineal muscle that plays a role in ejaculation.

What is the pelvic floor?

The “pelvic floor” is the group of muscles that form a sling or hammock across the floor of the pelvis. Together with surrounding tissues, these muscles hold the pelvic organs in place so they can function correctly. The pelvic organs include the bladder, urethra, intestines, and rectum. A woman’s pelvic organs also include the uterus, cervix, and vagina.

What is a PFD?

A PFD occurs when the pelvic muscles and connective tissue weaken or are injured. The most common types of PFDs are the following:

• Pelvic organ prolapse. “Prolapse” happens in women when the pelvic muscles and tissue can no longer support one or more pelvic organs, causing them to drop or press into the vagina. For instance, in uterine prolapse, the cervix and uterus can descend into the vagina and may even come out of the vaginal opening. In vaginal prolapse, the top of the vagina loses support and can drop toward or through the vaginal opening. Prolapse also can cause a kink in the urethra, the tube that brings urine from the bladder to the outside of the body.
• Bladder problems. Urinary symptoms can include urinating too often in the day or night, strong urgency to urinate, or urinary leakage. The leaking of urine, a problem called urinary incontinence, can occur in women or men. This leakage may occur as a result of an exertion (like a cough or sneeze) or other factors involving the bladder muscles. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) offers information about different types of bladder control problems, including these common types:
  • Stress incontinence
  • Urge or urgency incontinence (also called overactive bladder)
  • Overflow incontinence

Bowel control problems. The leaking of liquid or solid stool from the rectum, called fecal incontinence, can occur in women and men. It can result from damage to or weakening of the anal sphincter, the ring of muscles that keeps the anus closed, or from other causes. NIDDK also offers information on fecal incontinence.