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Embryology, Anatomy, and Physiology of the Male Reproductive System
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Male: ~18−20 cm longThe posterior urethra is proximal to the perineal membrane.Comprised of the prostatic and membranous urethra.The anterior urethra is distal to the perineal membrane.Contained within the corpus spongiosum.Comprised of the bulbar and penile urethra.
Anatomy
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
PerineAl MembrAne And ExternAl GenitAl Muscles In the Anterior portion of the pelvis, below the pelvic diAphrAgm, is A dense triAngulAr membrAne contAining A centrAl opening cAlled the perineAl membrAne (urogenitAl diAphrAgm). This lies At the level of the hymenAl ring And AttAches the urethrA, vAginA, And perineAl body to the ischiopubic rAmi. Just Above the perineAl membrAne Are the compressor urethrAe And urethrovAginAl sphincter muscles, previously discussed As pArt of the striAted urogenitAl sphincter muscle. recent dissections show the intimAte relAtionship between the perineAl membrAne And the levAtor Ani muscle (Figure 21.15); these Are in close proximity And so the Action of the muscle certAinly could influence the position of the perineAl membrAne [55]. the term "perineAl membrAne" replAces the old term "urogenitAl diAphrAgm," reflecting more AccurAte recent AnAtomic informAtion [56]. Previous concepts of the urogenitAl diAphrAgm show two fAsciAl lAyers, with A trAnsversely orientAted muscle between them (the deep trAnsverse perineAl muscle). observAtions bAsed on seriAl
Urogenital prolapse
Published in David M. Luesley, Mark D. Kilby, Obstetrics & Gynaecology, 2016
Sushma Srikrishna, Dudley Robinson
The urogenital diaphragm (perineal membrane) is a triangular sheet of dense fibrous tissue spanning the anterior half of the pelvic outlet, which is pierced by the vagina and urethra. It arises from the inferior ischiopubic rami and attaches medially to the urethra, vagina and perineal body, thus supporting the pelvic floor.
Could the bulbar urethral end location on the cystourethrogram predict the outcome after posterior urethroplasty for pelvic fracture urethral injury?
Published in Arab Journal of Urology, 2023
Ahmed M. Harraz, Adel Nabeeh, Ramy Elbaz, Abdalla Abdelhamid, Mohamed Tharwat, Amr A. Elbakry, Ahmed S. El-Hefnawy, Ahmed El-Assmy, Ahmed Mosbah, Mohamed H. Zahran
In the current study, the location of the proximal end of the bulbar urethra was an independent determinant of the failure rate regardless of the position or the length of the posterior urethra. In the vast majority of cases, the prostatic urethra and BN are hypothesized to be normal except on rare occasions such as in pediatric patients [16]. Conversely, the presence of the proximal end of the bulbar urethra superficially in zone A would indicate a more superficial injury, and less dissection is required to remove all scarred tissue compared if the urethral end is in zone B where the dissection should progress deeply in the pelvis. We have used an imaginary line in the center of a plane that is equivalent to the anatomical site of the perineal membrane between the pubic rami in the normal setting. This plane is arbitrary and is suggested as an objective tool to describe the depth of the bulbar urethra in relation to the pubic arch.
Statistical shape modeling of the pelvic floor to evaluate women with obstructed defecation symptoms
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Megan R. Routzong, Ghazaleh Rostaminia, Shaniel T. Bowen, Roger P. Goldberg, Steven D. Abramowitch
Pelvic floor traces—from pubic symphysis to coccyx—were segmented from the midsagittal MRI slice at each State (rest and peak evacuation) for each subject. This included level III vaginal support—including the perineal membrane and perineal body just superficial to the levator ani—anteriorly, the levator plate posteriorly, and the anal sphincter in between (Figure 1(a)). Segmentations were performed in 3D Slicer v4.10.1 by placing fiducial points along the pelvic floor starting at the inferior portion of the pubic symphysis and ending at the tip of the coccyx (Fedorov et al. 2012). 3D spline curves with a specified radial thickness were then generated by connecting those points and exported as meshed geometries (Figure 1(b)). To reduce computational costs, the 3D geometries were converted to 2D polylines by calculating a 2D spline along the midline of the surface mesh and evenly distributing 500 points along that curve using a custom Wolfram Mathematica v12.0.0 (Wolfram Research, Inc., Champaign, IL, USA) script. This ensured that only shape differences within the midsagittal plane would be considered in the following analyses.
Maintaining sexual function after pelvic floor surgery
Published in Climacteric, 2019
The female external genitalia consist of the labia (majora and minora), vestibule (interlabial space), and female erectile organs including the clitoris and vestibular bulbs. The clitoris comprises an outer glans, a middle corpus, and an inner crura, and the vestibular bulbs are erectile tissue located on either side of the female urethra. During sexual stimulation, the clitoris, labia minora, and vestibular bulbs become engorged. This results in increased lubrication, vaginal wall engorgement, and an increase in clitoral length and diameter. At the neurogenic level, nitric oxide, phosphodiesterase-V, and vasoactive intestinal peptide are believed to play a role in addition to the effect of the hormones estrogen and testosterone. The pelvic floor, on the other hand, forms the outlet of the bony pelvis and supports the abdominal and pelvic organs, maintains continence of urine and stool, and allows intercourse and parturition. It is formed by the levator ani muscle, urogenital diaphragm, and perineal membrane. The perineal membrane, consisting of the ischiocavernous, bulbocavernous, and superficial transverse perineal muscles, has a crucial role in sexual response.