So today we are going to do a tutorial about pelvic floor anatomy. Now, it is very interesting
to know that 1 in every 3 women do experience urinary incontinence, that means decreased
control of the urinary flow, in other words, leakage of urine with activities of daily
life, like walking, running, jumping, okay? 1 in 3 women. 1 in 2 women do end up experiencing
pain with intimacy after giving birth, no one talks about these symptoms, and no one
discusses these thinking that this is normal, but actually, this is not! It is common but
really not normal. So today we are going talk about pelvic floor anatomy, this is to help
you understand the exact structure of the pelvis and that way you can explain if you
ever experience any kind of pelvic symptoms, you are able to accurately explain to your
doctor or your health care provider, as to what is hurting, where is hurting, and what's
going on.
Okay, so I'm going to use a close to life size model of the pelvis, okay? So this is
a very close to a life size model of the Female Pelvis, anything that's white, that's bone,
and anything that's pink in this model is a muscle. So, let's look at this pelvic floor
from the bottom. We have 3 openings to the pelvic floor, one is the urethral opening,
so that's basically the area from which the urinary out pour comes, your urine flows,
right? The second is your vaginal opening, that's your opening to the vagina, and the
third is the rectal opening, so you see how closely all these muscles the pink structures
that are associated with these 3 openings, correct? So, that actually, is the layer 1
of the pelvic floor. So, pelvic floor is actually made up of 3 layers, okay? The most superficial
layer, is layer 1, this is the bulbospongiosus, so that is the muscle that covers along the
labia, so, remember the labia has been taken out of the model, this is the bulbospongiosus,
so I'm going to see the blue structure here, is interestingly enough, is a part of the
clitoris, so that's layer one. Now, this point right here, is actually the merging point
where all the muscles come together, in New York I explain to my patients this is the
Grand Central Terminal of the pelvic floor where all the muscles on there come together,
okay? So, this is the area where a lot of times we tear when we give birth, also there
is the episiotomy that's done right here, so if there's scarring that happens in this
area that could massively affect the way your pelvic floor works. Okay, so let's remove
the layer 1 and look inside. So, layer 2 of your pelvis is actually the sphincter layer,
which means, these muscles actually form sphincters or the closure of the urethra, that means
the tubes that come out of your pelvis, right? Your urethra, your vagina, so all these muscles
form the sphincter, not so glamorous! Okay, let's look into layer 3, so if you've ever
had any issues with the pelvis, a lot of times the doctor must have explained a words called
Levator Ani muscles are a group of muscles that we call as the layer 3 muscles of your
pelvic floor, these muscles go from the front of your pubis, to the back, that means your
sacrum, okay? actually, not the sacrum but the coccyx, the tailbone, these muscles are
actually 3 in number, and as a group they are called Levator Ani. Okay, so let's try
and see what these muscles look like, so the Puborectalis is the muscle that goes from
the Pubis, the front bone of your pelvis and goes around the rectum to come back to the
pubis, that's the Puborectalis Muscle. The next one, is your ischiococcygeous, that means
it goes from the side loops around and comes back, and the third one is the coccygeous
muscle, it directly attaches to the coccyx bone, so if you have any history of fall on
the tailbone that's very important and information you need to share with your health care provider,
or your doctor. Okay, the function of these Levator Ani muscles is to lift the pelvic
floor up, okay? Remember, innermost layer of your pelvic floor is responsible for lifting,
and the outer layer is basically going to help you squeeze the pelvic floor, okay? So,
remember, the outer layer squeezes, and the inner layer lifts. Why is this important?
Because I'm going to show you a series of videos after this in which I'm going to share
how Kegel exercises need to be done in the correct way, so that you get good results
doing kegels, and this information at that time is going to be extremely relevant, okay?
So, remember the outer layer squeezes, the inner layer, lifts, alright? So, I think that's
enough for today, for the tutorial, I hope you like this video, if you find this information
interesting, and useful! Try sharing this with all your friends, this is a topic that's
not discussed very often, and if it is, it's discussed with a taboo associated with it,
my mission to do these videos is to actually empower each and every women out there to
know what is accurate and what is scientifically or evidence based in the pelvic floor world,
so, please like, and please share, and let all of us be empowered through this information,
and help us on a journey to recovery and health of our core and pelvic floor. This is Dr Amruta
Inamdar, from New York, I have a practice here in New York, I also see patients online,
hope to see you soon!