The pelvic floor – sexual and medical co-morbidities

The pelvic floor is the anatomic, static and dynamic structure that inferiorly closes the pelvis and sustains the pelvic and abdominal organs. Its role is increasingly recognized in the etiology of different medical (urologic, gynecologic, proctologic, physiatric) and sexual conditions, contributing to a significant comorbidity [1]. The role of the pelvic floor overlaps with other biological factors. Embriologic affinity, anatomic contiguity, hormonal sensitivity, vulnerability to reproductive, coitus-related and iatrogenic and/or traumatic events [2], further contribute to the frequent and yet neglected co-morbidity between Urinary Incontinence (UI), Lower Urinary Tract Symptoms (LUTS) and Female Sexual Dysfunctions (FSD), specifically genital arousal disorders [3], dyspareunia and orgasmic difficulties [4]. New reading of clinical data indicate that a significant (and yet neglected) co-morbidity is also present with proctological and bowel diseases [5]. Latent classes analysis of sexual dysfunctions by risk factors in women indicate that urinary tract symptoms have a RR = 4.02 (2.75-5.89) of being associated with arousal disorders (and its most frequently reported associated symptom: vaginal dryness) and a RR=7.61 (4.06-14.26) of being associated with sexual pain disorders [6]. The presentation will discuss this co-morbidity in the lifespan perspective, with special focus on predisposing, precipitating and maintaining factors –biological, psychosexual and context-related- the clinician should pay attention to, for a comprehensive diagnosis and a well tailored etiologically oriented treatment [7]. The Overactive Bladder (OAB) is a frequent but underreported condition, affecting from 11.4 % to 17 % of women over 40 year. Fear of rejection