Invited Commentary

  • Anton Emmanuel


The concept of the “boat in dry dock” pioneered by John DeLancey has come to be recognized as central to our understanding of the biomechanics of the female pelvic floor. Failure, or more rarely rupture, of the connective tissue “ropes” allows the pelvic organs to descend through the urogenital hiatus. Additionally, collapse of the anterior vaginal wall allows formation of a cystocele, and if this affects the posterior vaginal wall a rectocele results. Frequently, but not invariably, these anatomical deficits result in symptoms — bladder or bowel evacuation and continence difficulties, and sexual dysfunction, as well as symptoms related to the physical presence of the prolapse. Quality of life is almost inevitably impaired, and over 10% of women from developed countries (in a society of increasing age) have undergone corrective pelvic floor surgery by the age of 80 years. The importance of conservative therapies for this condition is, therefore, of vital importance.


Irritable Bowel Syndrome Pelvic Floor Sexual Dysfunction Irritable Bowel Syndrome Patient Anterior Vaginal Wall 
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Copyright information

© Springer-Verlag Italia 2010

Authors and Affiliations

  • Anton Emmanuel
    • 1
  1. 1.GI Physiology UnitUniversity College HospitalLondonUK

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