[Pelvic floor disease].

Abstract

The pelvic floor is one of the most complex structures of the human body. Historically, the approach to pelvic floor disease has been "vertical": the anterior compartment was the domain of urologists, the middle compartment was the domain of gynecologists with frequent incursions into the female anterior compartment, and the posterior compartment was reserved for surgeons. In the last few years, a change has occurred in the philosophy underpinning the management of these diseases with the development of an integrative "cross sectional" approach which affects the physiology, physiopathology, and the definition of these diseases as an integrated structure, and which includes urinary and fecal incontinence, pelvic organ prolapse, alterations in the perception of urinary tract emptying, chronic constipation, sexual dysfunctions, and several chronic pain syndromes in the perineal area. We believe that the efforts of the various professionals involved in the treatment of these disorders should be pooled and that pelvic floor units should be created. These units should be characterized by a multidisciplinary approach, since the skills and knowledge necessary for the management of these patients requires teams composed of professionals with a broad range of competencies.