Standardization of terminology of pelvic floor muscle function and dysfunction: Report from the pelvic floor clinical assessment group of the International Continence Society

This report presents a standardization of terminology of pelvic floor muscle function and dysfunction. No earlier documents contained definitions on this terminology. These definitions are descriptive and do not imply underlying assumptions that may later prove to be incorrect or incomplete. By following this principle the International Continence Society aims to facilitate comparison of results and enable effective communication by investigators performing pelvic floor muscle studies. It is suggested that acknowledgement of these definitions in written publications be indicated by a footnote to the section "Methods and materials" or its equivalent, to read as follows: "Terminology used is conform the definitions recommended by the International Continence Society, except where specifically noted". The pelvic floor is related to more than one organ system. Dysfunction of the pelvic floor therefore influences different functions at the same time. This report is on pelvic floor muscle function and dysfunction and not on pelvic floor disorders. It contains no terminology on pelvic organ prolapse, urinary or faecal incontinence. Other reports refer to these subjects (Abrams et al, 2002, Weber et al, 2001, Bump et al 1996). This report on terminology of the pelvic floor muscles is written for use, in daily clinical practice, by every health care provider working with patients who have pelvic floor muscle problems. It facilitates the communication between different carers in the field of pelvic floor muscle pathology. Because it has been developed by a multidisciplinary group it can be used by different specialties. This document is based on our current knowledge of physiology and pathophysiology of the pelvic floor muscles. The pelvic floor The term pelvic floor relates to the compound structure, which closes the bony pelvic outlet. The term pelvic floor muscles refers to the muscular layer of the pelvic floor. The pelvic floor consists of different layers, the most cranial being the peritoneum of the pelvic viscera and the most caudal being the skin of vulva, scrotum and perineum (DeLancey 1992). The middle layers of the pelvic floor are made up of predominantly muscular tissue. Apart from the pure pelvic floor muscles, fibro-muscular and fibrous elements, like the endo-pelvic fascia, are found in this layer. Different well recognisable muscles together form the muscular layer of the pelvic floor: levator ani, striated urogenital sphincter, external anal sphincter,