This type of discomfort is also seen in some patients after hip surgery. While the hip joint and pelvic organ prolapse may seem unrelated, both conditions share a common factor: issues with the obturator internus, a key muscle of the pelvic floor.

When discussing the pelvic floor, many tend to focus solely on the levator ani. However, muscles like the obturator internus and piriformis, which are external rotators of the hip joint, are also integral components of the pelvic floor.

It is well-known that hip joint dysfunction can lead to obturator internus impairment, causing perineal discomfort or urinary incontinence. But why does a dysfunction in the obturator internus result in perineal discomfort?

The reason lies in the anatomical relationship: the pudendal nerve runs along the posterior surface of the obturator internus. Excessive stimulation or tension in the obturator internus can be perceived by the pudendal nerve as abnormalities within its sensory domain.

The pudendal nerve has superior, middle, and inferior branches that innervate different parts of the perineum. Depending on the branch affected, symptoms may appear in the clitoris and urethra (superior branch), the vagina (middle branch), or the anus (inferior branch).

To alleviate excessive stimulation of the obturator internus, the primary goal is to reduce tension. Treatment options may include rehabilitation, medications (e.g., herbal remedies, neuropathic pain relievers, muscle relaxants), magnetic stimulation therapy, hydrorelease, or shockwave therapy. Selecting appropriate therapies that target the muscle can help address the symptoms effectively.