The Importance of Puborectalis Muscle in Pelvic Floor Dysfunctions

Abstract

The pelvic floor is a musculofascial unit with synergistic and antagonistic activity. The pelvic floor muscles are a subset of the pelvic floor and an integral part of its functionality. The puborectalis muscle, an important component of this system, plays a critical role, particularly in maintaining continence and supporting the rectum. It determines the anorectal angle and facilitates the passage of feces by relaxing during defecation. Pathology in any of the anterior, middle or posterior compartments of the pelvic floor muscles can cause pelvic floor dysfunction (PFD) associated with lower urinary tract and bowel symptoms. The puborectalis muscle, which is usually associated with posterior compartment dysfunction, can in some cases exhibit paradoxical contractions, causing problems such as urgency, constipation and faecal incontinence. Increased thickness of the puborectalis muscle has been reported in patients with deep infiltrating endometriosis. Puborectal muscle thickness and function may be an important variable to consider in PFD. Accurate assessment of this muscle may increase the effectiveness of pelvic floor physiotherapy, which is the first-line treatment option in PFD. In order to shed light on current approaches to pelvic floor physiotherapy, we wanted to highlight the role and importance of the puborectalis muscle in intercompartmental pathologies.

Keywords

• Pelvic floor
• pelvic floor disorders
• pelvis.

Pelvik Taban Disfonksiyonlarında Puborektalis Kasının Önemi

Abstract

Pelvik taban, sinerjistik ve antagonistik aktivite gösteren muskulofasyal bir birimdir. Pelvik taban kasları, pelvik tabanın alt kümesi olup fonksiyonelliğin ayrılmaz bir parçasıdır. Bu sistemin önemli bir bileşeni olan puborektalis kası, özellikle kontinansın korunması ve rektumun desteklenmesi açısından kritik bir rol oynamaktadır. Anorektal açı üzerinde belirleyici bir etkiye sahiptir ve defekasyon sırasında gevşeyerek dışkı geçişini kolaylaştırmaktadır. Pelvik taban kaslarının anterior, orta veya posterior kompartmanlarından herhangi birinde oluşan bir patoloji alt üriner sistem ve bağırsak semptomlarıyla ilişkili pelvik taban disfonksiyonlarına (PTD) neden olabilir. Genellikle posterior kompartman disfonksiyonlarıyla ilişkilendirilen puborektalis kası, bazı durumlarda paradoksal kontraksiyonlar göstererek aciliyet hissi, konstipasyon ve fekal inkontinans gibi problemlere neden olabilir. Derin infiltre endometriozis hastalarında puborektalis kas kalınlığında artış bildirilmiştir. Puborektalis kas kalınlığı ve fonksiyonelliği PTD’de göz önünde bulundurulması gereken önemli bir değişken olabilir. Bu kasın doğru şekilde değerlendirilmesi PTD’de birinci basamak tedavi seçeneği olan pelvik taban fizyoterapisinin etkinliğini arttırabilir. Pelvik taban fizyoterapisine yönelik güncel yaklaşımlara katkı sağlamak amacıyla, kompartmanlar arası patolojilerde puborektalis kasının konumu ve önemini vurgulamak hedeflenmiştir.

Keywords

• Pelvik taban
• pelvik taban disfonksiyonları
• pelvis

Ethical Statement

Geçerli değil

References

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