Review

Fascial continuity of the pelvic floor with the abdominal and lumbar region

  • ANDREA RAMIN
  • VERONICA MACCHI
  • ANDREA PORZIONATO
  • RAFFAELE DE CARO
  • CARLA STECCO

Pelviperineology 2016;35(1):3-6

Introduction:

The connection between the pelvic floor, abdomen and lower back is clinically recognized but the anatomical basis of this link requires further clarification. The purpose of this work was to review the literature on pelvic fasciae, in order to provide a description of their continuity with the fasciae of abdominal muscles and lower back.

Materials and Methods:

A search of the literature was conducted on the PubMed database, using keywords that contain the term “fascia” in relation to different anatomical regions. The list of articles found was reviewed for relevant publications and a total amount of 41 scientific works was considered suitable for our investigation. For further research we used international reference texts on Anatomy.

Discussion:

The review of the literature confirms our idea of a fascial continuity and describes its development, at several levels: 1) superficial fascia; 2) superficial layer of the deep fascia; 3) deep layer of the deep perineal fascia; this layer can be divided into two separate layers by the levator ani muscle.

Conclusion:

Anatomically, the continuity in the fasciae of the abdominal wall, pelvic floor and lumbar region is plausible. A “new” theory of fascial anatomical continuity could have implications in the understanding of the clinical presentation of pelvic pain, the comprehension of the anatomical link between abdominal-lumbar disorders and pelvic floor, and in the treatment of chronic pain conditions, leading to an enhancement in current anatomical knowledge and therapies.

Keywords: Colles fascia; Urogenital diaphragm; Pelvic floor; Integral theory; Fascia.