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Title of Journal: Int Urogynecol J

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Abbravation: International Urogynecology Journal

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Springer-Verlag

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DOI

10.1007/bf01629478

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1433-3023

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The Role of the Levator Ani Muscle in Evacuation

Authors: A Shafik
Publish Date: 2014/02/22
Volume: 11, Issue: 6, Pages: 361-376
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Abstract

This paper reviews the role of the levator ani muscle LAM in evacuation sexual performance and pelvic floor disorders The LAM fixes the vesical neck anorectal junction and vaginal fornices to the side wall of the pelvis by means of the suspensory sling and hiatal ligament On contraction it shares in the mechanism of evacuation urination defecation During the sexual act vaginal distension by the erect penis evokes the vaginolevator and vaginopuborectalis reflexes with a resulting LAM contraction The LAM also contracts upon stimulation of the clitoris or cervix uteri an action mediated through clitoromotor and cervicomotor reflexes LAM contraction leads to upper vagina ballooning which acts as receptacle for semen collection to uterine elevation and straightening and to elongation and narrowing of the vagina These actions enhance the sexual response and prepare the uterus and vagina for the reproductive process During ejaculation LAM contraction facilitates semen ejection Levator subluxation and sagging leads to levator dysfunction syndrome which may present as pudendal canal syndrome

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