ABSTRACT
The concept of horizontal integration of pelvic floor function, rather than the traditional vertical approach, provides a comprehensive assessment of the pelvic floor with a multidisciplinary team approach. Innervation of the pelvic floor is accomplished by the parasympathetic and sympathetic autonomic and peripheral somatic motor and sensory systems. The somatic nerves provide innervation to the striated muscle of the external urethral sphincter and the muscles of the pelvic floor along the Pudendal nerve. In the gynecological history, attention to prior pelvic incontinence and/or reconstructive surgeries should be noted hormonal status, any gynecologic malignancy and treatments, sexual history, and complaints. The pelvic examination begins with the patient in lithotomy position followed by inspection of the perineal skin and external genitalia for signs of hypoestrogenism such as atrophy or agglutination of the labia. Pelvic floor muscle training involves contraction of the pelvic floor or levator ani muscles to assist in controlling urinary leakage in women with both stress and mixed incontinence.
