The variation in shape and thickness of the pelvic floor musculature in males and females: a geometric-morphometric analysis

Abstract

Introduction and hypothesis In women, the risk of pelvic floor prolapse is known to be associated with age and parity. Different studies suggested that it is also related to pelvic dimensions, e.g. biomechanical modelling showed that a larger pelvic canal results in higher values of displacement, stress and strain in the pelvic floor muscles, which can increase the risk of pelvic floor disorders. To better understand the multiple factors contributing to pelvic floor disorders, we assessed how age, body weight, body height, parity (in women), pelvic canal size and overall muscle development affected pelvic floor geometry. Methods A comprehensive geometric morphometric analysis of variation in pelvic floor muscle shape was conducted based on a dense set of 3D landmarks measured on CT scans in a cohort of 49 deceased men and 52 deceased women. The multivariate association between biological variables (parity, dimensions of the true pelvis, age, body weight, height) and pelvic floor muscle morphology was explored by reduced rank regression in both sexes. Results In women, advanced age, high body weight relative to body height and a large pelvic canal were associated with a deeper pelvic floor. Surprisingly, parity did not have any strong association with overall pelvic floor shape. In men, high body weight was associated with a deep pelvic floor. Age had little effect on male pelvic floor shape, except for the thickness of the ischiocavernosus muscle, which reduced with age. Conclusion These results suggest that age, relative body weight and the size of the pelvic canal contribute to the risk of female pelvic floor disorders via their effect on pelvic floor shape, independently of birth-related factors such as injury and avulsion of pelvic floor muscles.

A classification of the plantar intrinsic foot muscles based on the physiological cross‐sectional area and muscle fiber length in healthy young adult males

“…Thus, if the individual samples in the dataset have a vast variety of muscle morphological profiles, k‐means clustering analysis may fail to function for addressing the purpose of this study, which was to examine how individual PIFMs can be classified based on their morphological parameters. Currently, it is unknown whether morphological profiles of the PIFMs are affected by sex and/or age, but sex differences have been found to exist in other muscles such as those in the lower/upper extremities [20–22] and around the pelvis [40]. Thus, more studies are needed to further examine sex differences in morphological profiles of the PIFMs and the applicability of the current results to other populations, such as females.…”

Quantitative 3D Analysis of Levator Ani Muscle Subdivisions in Nulliparous Women: MRI Feasibility Study

“…A further limitation of our study is the retrospective study design with imaging not originally undertaken for morphometric research purposes. Larger patient collectives will be needed to gain normative values for the LAM muscle in healthy nulliparous women, corrected for pelvic size, gender and ethnicity [29]. Studies have reported differences in the bony architecture of the pelvis in women with and without pelvic floor disorders as well as between different ethnic groups [30,31].…”