Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Siess, M.
On the potential morpho-mechanical link between the gluteus maximus and pelvic floor tissues
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2024. pp. 67
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Hammer Niels
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- Abstract:
- Stress urinary incontinence is a condition that affects not only elderly females but also young female athletes performing in high-impact sports like volleyball and trampolining. Repetitive jumping seems to be an aggravating factor. In general, lax vaginal tissues and weakened supporting structures can lead to stress and urge incontinence. However, the underlying pathophysiology remains incompletely understood, particularly concerning the impact of the surrounding buttock tissues, including the gluteus maximus muscle. The study aimed to investigate the morpho-mechanical relationship between the gluteus maximus and the female pelvic floor. The study involved the dissection of 25 pelves from Thiel-embalmed female cadavers while in a supine position. The mechanical properties of tissue strands connecting the gluteus maximus to the urogenital diaphragm were assessed in 20 specimens. Plastinates were also evaluated to confirm the dissection findings. In total, data were collected from 49 hemipelves. The investigation revealed that the fascia of the gluteus maximus extends to the subcutaneous tissue, the fascia of the external anal sphincter, the fascia of the internal obturator, and the fascia of the urogenital diaphragm. This link to the internal obturator and the urogenital diaphragm can be regarded as an extension of the gluteus maximus fascia. The connection between the gluteus maximus and the urogenital diaphragm was able to withstand an average force of 23.6 ± 17.3 N. Cramér φ analyses demonstrated consistent connections of the fasciae linking the gluteus maximus with its surroundings in both the horizontal and sagittal planes. In conclusion, the study showed that the gluteus maximus is closely linked to the pelvic floor through connective tissue strands and fascial continuations covering the adjacent muscles. While previous research has suggested that the gluteus maximus supports urinary continence, the here-described morpho-mechanical link suggests that it may potentially also play a role in urinary stress incontinence. Future research that combines clinical imaging with in-situ testing may provide additional insights into the clinical implications of these findings.