Abstract
The coordinated function of pelvic floor muscles (PFM) and related organs is an important pre-requisite that enables women to be continent of urine and feces, to micturate and defecate, and to experience orgasm. It is dependent on a complex neurocontrol consisting of voluntary muscle actions and reflexes, genetically determined activation patterns allowing for a meticulous interplay of skeletal and autonomous muscle structures, and related organs. This scientifically complicated material is broken down in this chapter to a very understandable and practical level, which is a basic necessity for sophisticated pelvic floor physiotherapy.
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References
Deindl FM, Vodusek DB, Hesse U, et al. Activity patterns of pubococcygeal muscles in nulliparous continent women. Br J Urol. 1993;72:46–51.
Deindl FM, Vodusek DB, Hesse U, et al. Pelvic floor activity patterns: comparison of nulliparous continent and parous urinary stress incontinent women. A kinesiological EMG study. Br J Urol. 1994;73:413–417.
Kenton K, Brubaker L. Relationship between levator ani contraction and motor unit activation in the urethral sphincter. Am J Obstet Gynecol. 2002;187:403–406.
Chantraine A. Examination of the anal and urethral sphincters. In: Desmedt JE, editor. New developments in electromyography and clinical neurophysiology. Volume 2. Basel: Karger, 1973: 421–432.
Vodusek DB. Neurophysiological study of sacral reflexes in man (in Slovene). Institute of Clinical Neurophysiology. Ljubljana: University E. Kardelj in Ljubljana, 1982.
Read NW. Functional assessment of the anorectum in faecal incontinence. Neurobiology of incontinence (Ciba Foundation Symposium 151). Chichester, New York, Brisbane, Toronto, Singapore: John Wiley, 1990.
Borghi F, Di Molfetta L, Garavoglia M, et al. Questions about the uncertain presence of muscle spindles in the human external anal sphincter. Panminerva Med. 1991;33:170–172.
Vodusek DB, Janko M. The bulbocavernosus reflex. A single motor neuron study. Brain. 1990; 113(Pt 3):813–820.
Sundin T, Petersen I. Cystometry and simultaneous electromyography from the striated urethral and anal sphincters and from levator ani. Invest Urol. 1975;13:40–46.
Vodusek DB. Electrophysiology. In: Schussler B, Laycock J, Norton P, et al, editors. Pelvic floor re-education: principles and practice. London: Springer-Verlag, 1994.
McCloskey DI. Corollary changes: motor commands and perception. In: Brookhart JM, Mountcastle VB, editors. Handbook of physiology. Section I. The nervous system. Volume 2 (Part 2). Bethesda, MD: American Physiological Society, 1981.
Morrison JFB. Reflex control of the lower urinary tract. In: Torrens M, Morrison JF, editors. The physiology of the lower urinary tract. London: Springer-Verlag, 1987.
Mannen T, Iwata M, Toyokura Y, Nagashima K. The Onuf’s nucleus and the external anal sphincter muscles in amyotrophic lateral sclerosis and Shy-Drager syndrome. Acta Neuropathol (Berl). 1982;58:255–260.
Schroder HD. Anatomical and pathoanatomical studies on the spinal efferent systems innervating pelvic structures. 1. Organization of spinal nuclei in animals. 2. The nucleus X-pelvic motor system in man. J Auton Nerv Syst. 1985;14:23–48.
Barber MD, Bremer RE, Thor KB et al. Innervation of the female levator ani muscles. Am J Obstet Gynecol. 2002;187:64–71.
Bannister LH, ed. Gray’s anatomy. The anatomical basis of medicine and surgery. 38th edition. New York, London: Churchill Livingstone, 1995.
Marani E, Pijl ME, Kraan MC et al. Interconnections of the upper ventral rami of the human sacral plexus: a reappraisal for dorsal rhizotomy in neurostimulation operations. Neurourol Urodyn. 1993;12:585–598.
Blok BF, Sturms LM, Holstege G. A PET study on cortical and subcortical control of pelvic floor musculature in women. J Comp Neurol. 1997;389: 535–544.
Holstege G. The emotional motor system in relation to the supraspinal control of micturition and mating behavior. Behav Brain Res. 1998;92:103–109.
Vodusek DB. Evoked potential testing. Urol Clin North Am. 1996;23:427–446.
Brostrom S. Motor evoked potentials from the pelvic floor. Neurourol Urodyn. 2003;22: 620–637.
Ueyama T, Mizuno N, Nomura S, et al. Central distribution of afferent and efferent components of the pudendal nerve in cat. J Comp Neurol. 1984;222:38–46.
Torrens M, Morrison JF, editors. The physiology of the lower urinary tract. London: Springer-Verlag, 1987.
Blok BF, van Maarseveen JT, Holstege G. Electrical stimulation of the sacral dorsal gray commissure evokes relaxation of the external urethral sphincter in the cat. Neurosci Lett. 1998;249:68–70.
Blok BF, Holstege G. The central nervous system control of micturition in cats and humans. Behav Brain Res. 1998;92:119–125.
Miller JM, Ashton-Miller JA, DeLancey JO. A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc. 1998;46:870–874.
Bartolo DC, Macdonald AD. Fecal continence and defecation. In: Pemberton JH, Swash M, Henry MM, editors. The pelvic floor. Its function and disorders. London: W. B. Saunders, 2002: 77–83.
Fucini C, Ronchi O, Elbetti C. Electromyography of the pelvic floor musculature in the assessment of obstructed defecation symptoms. Dis Colon Rectum. 2001;44:1168–1175.
Stoleru S, Gregoire MC, Gerard D, et al. Neuroanatomical correlates of visually evoked sexual arousal in human males. Arch Sex Behav. 1999; 28:1–21.
Petersen I, Franksson C, Danielson CO. Electromyographic study of the muscles of the pelvic floor and urethra in normal females. Acta Obstet Gynecol Scand. 1955;34:273–285.
Vodusek DB. Sacral reflexes. In: Pemberton JH, Swash M, Henry MM, eds. Pelvic floor. Its functions and disorders. London: Saunders, 2002.
Blaivas JG, Sinha HP, Zayed AA, Labib KB. Detrusor-external sphincter dyssynergia: a detailed electromyographic study. J Urol. 1981;125: 545–548.
Pavlakis AJ, Siroky MB, Goldstein I, Krane RJ. Neurourologic findings in Parkinson’s disease. J Urol. 1983;129:80–83.
Rudy DC, Woodside JR. Non-neurogenic neurogenic bladder: The relationship between intravesical pressure and the external sphincter electromyogram. Neurourol Urodyn. 1991;10:169.
Mathers SE, Kempster PA, Law PJ, et al. Anal sphincter dysfunction in Parkinson’s disease. Arch Neurol. 1989;46:1061–1064.
van der Velde J, Laan E, Everaerd W. Vaginismus, a component of a general defensive reaction. An investigation of pelvic floor muscle activity during exposure to emotion-inducing film ex-cerpts in women with and without vaginismus. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12:328–331.
Graziottin A, Bottanelli M, Bertolasi L. Vaginismus: a clinical and neurophysiological study. Urodinamica. 2004;14:117–121.
Podnar S, Oblak C, Vodusek DB. Sexual function in men with cauda equina lesions: a clinical and electromyographic study. J Neurol Neurosurg Psychiatry. 2002;73:715–720.
Vodusek DB. The role of electrophysiology in the evaluation of incontinence and prolapse. Curr Opin Obstet Gynecol. 2002;14:509–514.
Verelst M, Leivseth G. Are fatigue and disturbances in pre-programmed activity of pelvic floor muscles associated with female stress urinary incontinence? Neurourol Urodyn. 2004;23:143–147.
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Vodušek, D.B. (2008). Neural Control of Pelvic Floor Muscles. In: Baessler, K., Burgio, K.L., Norton, P.A., Schüssler, B., Moore, K.H., Stanton, S.L. (eds) Pelvic Floor Re-education. Springer, London. https://doi.org/10.1007/978-1-84628-505-9_2
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DOI: https://doi.org/10.1007/978-1-84628-505-9_2
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