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Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The Goldman classification helps to distinguish between the different types of injury. The important landmark is the urogenital diaphragm. If the contrast extravasates into the retropubic space it suggests injury above the urogenital diaphragm. Conversely, if the contrast leaks into the perineum it suggests injury below the urogenital diaphragm. Above the urogenital diaphragm relates to the posterior urethra.
Pelvis and perineum
Published in David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings, McMinn’s Concise Human Anatomy, 2017
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings
Urogenital triangle - the anterior part of the perineum and forming its floor is the urogenital diaphragm, a sheet of fascia joining the ischiopubic rami together. Between this fascia and the more superficial skin is the superficial perineal pouch. However, the urogenital diaphragm can be thought of as containing a space, known as the deep perineal pouch, where the important voluntarily controlled sphincter urethrae (external urethral sphincter), through which the urethra passes, is located. Posteriorly the urogenital diaphragm has a free edge to which attaches the posterior edge of the membranous fascia (which lies just deep to the skin over the urogenital skin, closing off the superficial perineal pouch [space]), which contains the erectile tissues that attach to the inferior layer of the diaphragm (see below) and, in the male, to the testis.
Genitourinary, adrenal and breast
Published in Dave Maudgil, Anthony Watkinson, The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Dave Maudgil, Anthony Watkinson
Are the following statements regarding the urethra true or false? The bulbous urethra traverses the urogenital diaphragm.The penile urethra contains the fossa navicularis.Urethrography should be avoided for a month following urethral instrumentation.Active urethritis is a contraindication to urethrography.A 16F catheter is suitable for urethrography.
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.