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Le syndrome du plancher pelvien hyperactif (SPPH)

Aspects psychosomatiques et psycho-sexuels des troubles du plancher pelvien associés à des symptômes uro-gynécologiques, gastro-intestinaux et sexuels

The hyperactive pelvic floor syndrome (HPFS)

Psychosomatic and psycho-sexual aspects of hyperactive pelvic floor disorders with co-morbidity of uro-gynaecological, gastro-intestinal and sexual symptomatology

  • Published:
Acta Endoscopica

Résumé

L’hyperactivité chronique de la musculature du plancher pelvien, caractérisée par des plaintes urinaies, gynécologiques, gastro-intestinales et sexuelles, est associée à des troubles de l’humeur, de l’anxiété, des problèmes de relation sexuelles, voire des expériences sexuelles et/ou physiques traumatisantes.

Sur la base de données scientifiques disponibles et d’observation cliniques, un schéma théorique de la pathogénie des troubles du plancher pelvien hyperactif a été établi afin de pouvoir définir le Syndorme du Plancher Pelvien Hyperactif (SPPH). A propos de l’étiologie de ce syndrome, qui inclut des symptômes des fonctions gastro-intestinales, uro-génitales et sexuelles dans un contexte de co-morbidité, des hypothèses ont été testées lors d’une approche clinique multidisciplinaire du diagnostic et du traitement symptomatique complexe de tels patients. Ceux-ci présentent dans leus antécédents des échecs de traitements médicaux, chirugicaux et psychiatriques, ignorant les aspects pscyhopathologiques de la tension musculaire consécutive à des troubles psychologiques, psychosociaux et/ou psychosexuels et responsables de symptômes eux-mêmes figés dans un cercle vicieux qui associe, la douleur, l’anxiété et la tension musculaire.

Summary

Chronic hyperactivity of pelvic floor musculature characterized by co-morbidity of urological, gynaecological, gastro-intestinal and sexological complaints is associated with mood disorders, sexual dysfunctions, anxiety disorders and traumatic sexual and/or physical experiences.

Based on a review of available scientific data and on clinical observations a theoretical framework for the pathogenesis of hyperactive pelvic floor disorders is conceptualized in defining the Hyperactive Pelvic Floor Syndrome (HPFS). Hypotheses on the etiology of this syndrome with comorbidity of symptoms concerning gastro-intestinal, uro-genital and sexual functions are operationalized in a multifacettal, multidisciplinary clinical approach in diagnosis and treatment of the complex symptomatology of patients with long histories of unsuccessful medical, surgical and psychiatric treatments that in general do not take into account the psychophysiological aspects of muscle tension originating from psychological, psycho-social and/or psycho-sexual distress and resulting in physical symptoms that tend to be fixated by a vicious circle of pain, anxiety and muscle tension.

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  1. Dept. Sexology & Psychosomatic Ob/Gyn, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, (The Netherlands)

    R. H. W. Van Lunsen & M. J. Ramakers MD

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  1. R. H. W. Van Lunsen
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  2. M. J. Ramakers MD
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Correspondence to R. H. W. Van Lunsen.

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Van Lunsen, R.H.W., Ramakers, M.J. Le syndrome du plancher pelvien hyperactif (SPPH). Acta Endosc 32, 275–285 (2002). https://doi.org/10.1007/BF03020230

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