Bipedalism and pelvic floor disorders, an evolutionary medical approach

Evolutionary medicine can help to better understand the basis of pelvic floor disorders. Some evidences of the anthropological literature are reviewed, with emphasis on the paleontological clues and phylogenetic comparison of cephalo-pelvic relations in Homo and non-human primates, is undertaken to elucidate the origin of pelvic floor disturbances in humans. Labor difficulties inherent to bipedal gait and the encephalization process could have started several million years ago with Australopithecus and appear undeniable since Homo heidelbergensis, the precursor of Neanderthals. The mechanisms involved in modern human delivery with fetal rotation into the birth canal could be exclusive of Homo sapiens. Among pre-bipedal non-human primates only squirrel monkey can suffer severe dystocia and spontaneous pelvic organ prolapse. Better understanding of the evolutionary changes regarding the human pelvis and the pelvic floor could help us to better understand pelvic floor disorders and the interventions to avoid this highly prevalent ailment.