World Journal of Urology

, Volume 30, Issue 4, pp 429–435 | Cite as

Accuracy of concepts in female pelvic floor anatomy: facts and myths!

Topic paper

Abstract

The pelvic floor is characterized by a complex morphology because different functional systems join here. Since a clear understanding of the pelvic floor region is crucial for female pelvic surgery and fundamental mechanisms of urogenital dysfunction and treatment, we here describe the accurate and functional anatomy of important pelvic structures and landmarks, clarify their terminology and point out possible errors or misunderstandings as to their existence.

Keywords

Female pelvic floor Subperitoneal connective tissue Fascia, septum and ligament Nerve vessel guiding plates 

References

  1. 1.
    Aigner F, Zbar AP, Ludwikowski B, Kreczy A, Kovacs P, Fritsch H (2004) The rectogenital septum: morphology, function and clinical relevance. Dis Colon Rectum 47:131–140PubMedCrossRefGoogle Scholar
  2. 2.
    Berglas B, Rubin IC (1953) Histologic study of the pelvic connective tissue. Surg Gynecol Obstet 97:277–289PubMedGoogle Scholar
  3. 3.
    Brökelmann J (1985) Die weiblichen Geschlechtsorgane. In: Fleischhauer K (ed) Beninghoff Bd. 2 13./14. Auflage, Urban & Schwarzenberg, MünchenGoogle Scholar
  4. 4.
    De Blok S (1982) The connective tissue of the female fetal pelvic region. Acta Morphol Neerl Scand 20:65–92PubMedGoogle Scholar
  5. 5.
    De Blok S (1982) The connective tissue of the adult female pelvic region. Acta Morphol Neerl Scand 20:325–346PubMedGoogle Scholar
  6. 6.
    DeLancey JO (2006) Anatomy. In: Cardozo L, Staskin D (eds) Textbook of female urology and urogynecology. Informa Healthcare, London, pp 115–126Google Scholar
  7. 7.
    Dorschner W, Stolzenburg JV, Neuhaus J (2001) Structure and function of the bladder neck. Adv Anat Embryol Cell Biol 159:1–109CrossRefGoogle Scholar
  8. 8.
    Fritsch H (1990) Development of the rectal fascia. Anat Anz 170:273–280PubMedGoogle Scholar
  9. 9.
    Fritsch H (1992) The connective tissue sheath of uterus and vagina in the human female fetus. Ann Anat 174:261–266PubMedCrossRefGoogle Scholar
  10. 10.
    Fritsch H, Lienemann A, Brenner E, Ludwikowski B (2004) Clinical anatomy of the pelvic floor. Adv Anat Embryol Cell Biol 175:1–64CrossRefGoogle Scholar
  11. 11.
    Fritsch H, Pinggera GM, Lienemann A, Mitterberger M, Bartsch G, Strasser H (2006) What are the supportive structures of the female urethra? Neurourol Urodyn 25:128–134PubMedCrossRefGoogle Scholar
  12. 12.
    Fujii S, Takakura K, Matsumura N, Higuchi T, Yura S, Mandai M, Baba T, Yoshioka S (2007) Anatomic identification and functional outcomes of nerve sparing Okabayashi radical hysterectomy. Gynecol Oncol 107:4–13PubMedCrossRefGoogle Scholar
  13. 13.
    Heald RJ (1995) Total mesorectal excision is optimal surgery for rectal cancer. Br J Surg 82:1297–1299PubMedCrossRefGoogle Scholar
  14. 14.
    Höckel M, Horn L-C, Fritsch H (2005) Local tumor spread in stage IB–IIB cervical carcinoma is confined to the mesenchymal compartment of uterovaginal organogenesis. Lancet Oncol 6:751–756PubMedCrossRefGoogle Scholar
  15. 15.
    Koster H (1933) On the supports of the uterus. Am J Obstet Gynecol 25:67–74Google Scholar
  16. 16.
    Otcenasek M, Baca V, Krofta L, Feyereisl J (2008) Endopelvic fascia in women: shape and relation to parietal pelvic structures. Obstet Gynecol 11:622–630CrossRefGoogle Scholar
  17. 17.
    Pernkopf E, Pichler A (1953) Systematische und topographische Anatomie des weiblichen Beckens. In: Seitz L, Amreich J (eds) Biologie und Pathologie des Weibes Bd. 1/1. Urban & Schwarzenberg, Berlin, pp 83–194Google Scholar
  18. 18.
    Petros P (2007) The female pelvic floor. Springer, HeidelbergGoogle Scholar
  19. 19.
    Petros PEP, Woodman PJ (2008) The integral theory of continence. Int Urogynecol J 19:35–40CrossRefGoogle Scholar
  20. 20.
    Range RL, Woodburne RT (1964) The gross and microscopic anatomy of the transverse cervical ligaments. Am J Obstet Gynecol 90:460–467PubMedGoogle Scholar
  21. 21.
    Reisenauer C, Shiozawa T, Oppitz M, Busch C, Kirschniak A, Fehm T, Drews U (2008) The role of smooth muscle in the pathogenesis of pelvic organ prolapse- an immunohistochemical and morphometric analysis of the cervical third of the uterosacral ligament. J Pelvic Foor Dysfunct 19:383–389CrossRefGoogle Scholar
  22. 22.
    Richter K (1998) Gynäkologische Chirurgie des Beckenbodens. Georg Thieme Verlag, StuttgartGoogle Scholar
  23. 23.
    Shiozawa T, Huebner M, Hirt B, Wallwiener D, Reisenauer C (2010) Nerve-preserving sacrocolpopexy: anatomical study and surgical approach. Eur J Obstet Gynecol Reprod Biol 152:103–107PubMedCrossRefGoogle Scholar
  24. 24.
    TA = Federative committee on anatomical terminology (1998) Terminologia Anatomica, International Anatomical Terminology. Georg Thieme Verlag, StuttgartGoogle Scholar
  25. 25.
    Tandler J (1923) Lehrbuch der systematischen Anatomie. Die Eingeweide. Bd. 2 Vogel, LeipzigGoogle Scholar
  26. 26.
    Trimbos JB, Maas CP, Deruiter MC, Peters AA, Kenter GG (2001) A nerve-sparing radical hysterectomy: guidelines and feasibility in Western patients. Int J Gynecol Cancer 11:180–186PubMedCrossRefGoogle Scholar
  27. 27.
    von Peham H, Amreich J (1930) Gynäkologische Operationslehre. Karger, BerlinGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Section of Clinical and Functional Anatomy, Department of Anatomy, Histology and EmbryologyMedical University of InnsbruckInnsbruckAustria
  2. 2.Obstetrics and Gynecology, Landesklinikum Thermenregion MödlingMödlingAustria

Personalised recommendations