Effect of abdominal and pelvic floor tasks on muscle activity, abdominal pressure and bladder neck

Although the bladder neck is elevated during a pelvic floor muscle (PFM) contraction, it descends during straining. This study aimed to investigate the relationship between bladder neck displacement, electromyography (EMG) activity of the pelvic floor and abdominal muscles and intra-abdominal pressure (IAP) during different pelvic floor and abdominal contractions. Nine women without PFM dysfunction performed maximal, gentle and moderate PFM contractions, maximal and gentle transversus abdominis (TrA) contractions, bracing, Valsalva and head lift. Bladder neck position was assessed with perineal ultrasound. PFM and abdominal muscle activities were recorded with a vaginal probe and fine-wire electrodes, respectively. IAP was recorded with a rectal balloon. Bladder neck elevation only occurred during PFM and TrA contractions. PFM EMG and IAP increased during all tasks from 0.5 (gentle TrA) to 45.7 cmH(2)O (maximal Valsalva). Bladder neck elevation was only observed when the activity of PFM EMG was high relative to the IAP increase.