Chapter 2: Knowing your intimate anatomy intimately
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We all learned about the human body in school. We read some popular science books. Some of us took biology classes or anatomy as a major. We had teachers referring to the human body as an incredible machine. Students admire the heart, the muscle relentlessly pumping blood 60-100 times a minute for a lifetime. Our eyes, constructed like a sophisticated camera fascinate us.

Somehow, probably because sex, urination, and defecation are taboo subjects, we all ignore how important the pelvic floor is and the lower urinary system it supports. Only when something goes wrong do we start to appreciate how that pelvic floor and bladder served us well without our having paid any attention to its functions till then.

Our urinary system is designed to enable us to keep our fluids and salts (or electrolytes) at relatively constant levels. To do so, the kidneys, a pair of fist-size organs, filter our blood constantly, but these are not like the ordinary filtering systems that we are used to seeing. Kidney filtering is not based solely on the size of the particles like our kitchen strainer or the air or fuel filters in our cars, but also on their chemical makeup (entity) or configuration. The kidneys are equipped with special elements called receptors able to identify different salt particles and other blood constitutes. The receptors can then facilitate the elimination of certain particles into the urine as a waste product or help in keeping them as a valuable asset for the body to use. The filtered urine and its constitutes then flows through a collecting system and will eventually be excreted by the body.

To get a better grasp of how this collecting system is designed, look at Figure 1 (image on the left - click on graphic to see a larger image- Illustration by Florence Adar). You will see a sketch of two rivers flowing toward a large body of water—a reservoir created by a gated dam. Water reaching the reservoir is slowly collected but can be emptied once the gate is open.

 

Our collecting system is very similar (refer to graphic at right- Illustration by Florence Adar): The urine (water) created by the kidneys flows down the rivers channeled into tunnels (the ureters) into the reservoir (the urinary bladder) where it is collected. Once social circumstances allow, the bladder is emptied through a tube (the urethra), gated by muscles that can open and close the opening at the appropriate time (the sphincter).

The pelvic floor is a plate-like structure of muscles and connective tissues that support our pelvic organs: the urethra, bladder, rectum, and vagina. Without the pelvic floor we would be exposed to the rather unsightly display of our pelvic organs and perhaps other internal organs “falling out” or left behind us when we get out of our chair.
The pelvic floor is not a simple or inert structure either. Besides supporting the pelvic structures it serves many other functions such as bladder and bowel control, and for sexual intercourse.

The best way to demonstrate how our pelvic floor works is to compare it with a structure most of us are much more familiar with—a building.

Imagine a floor on a high rise building (refer to graphic on the right- Illustration by Florence Adar). The floor is strong enough to support our appliances and our furniture. There are openings on each floor: an elevator shaft, openings for electrical wiring, and for water and sewage pipelines.
Our pelvic floor (refer to the graphic on the left- Illustration by Florence Adar) is also a supporting structure with tubes and canals running through it (the urethra, vagina, and rectum), but there the similarity ends.  The pelvic floor is a muscular structure. It keeps a basic level of support most of the time. It can, however, contract—as it does every time you cough or sneeze or whenever urination and defecation are not socially acceptable (like meeting with your boss or being stuck in your car waiting for the red light to change). It can also relax in the proper social circumstances allowing bladder emptying and bowel movements. No building could adjust an elevator a few times bigger than the original size of its shaft. This does takes place within a woman’s body, sometimes more than once in a lifetime during childbirth.