A 67 year-old woman complains of decreasing ability to make it to the bathroom before urinating. She reports that the problem started intermittently “a few years ago,” but is now almost a daily occurrence. Past obstetric history is significant for six normal vaginal deliveries. You recommend daily exercises to strengthen muscles of the urogenital diaphragm. Strengthening which of the following muscles will most help the woman’s incontinence?
Gluteus minimus
Levator ani
Obturator internus
Piriformis
Pubococcygeus
Correct answer
Pubococcygeus
explanation
The pubococcygeus most directly controls urine flow and is the muscle that contracts during orgasm. It surrounds the anus, the bladder opening, and, in women, the vagina. The pubococcygeus extends from the pubic bone to the coccyx.