Pelvis and perineum
Aida Lai in Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Differences between male and female pelvises– female pelvis is wider between ischial spines and tuberosities– female pelvis inlet and outlet are wider– female pelvis inlet is oval-shaped– male pelvis inlet is heart-shaped– female pelvis has lighter bones– female pelvis has wider pubic arch (angle at pubic symphysis)– male pelvis has more prominent sacral promontory
Central recurrent cervical cancer: The role of exenterative surgery
J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan in An Atlas of Gynecologic Oncology, 2018
The patient is placed in the extended lithotomy position and an incision made to remove the lower vagina (for an anterior exenteration) or the lower vagina and rectum (for a total exenteration) (Figure 13.9). Anteriorly the incision is carried through above the urethra just below the pubic arch to enter the space of the cave of Retzius which has been dissected in the pelvic procedure. The dissection is carried laterally and posteriorly, dividing the pelvic floor musculature, and the entire block of tissue is then removed through the inferior pelvic opening. Small amounts of bleeding will occur at this point, usually arising from the edge of the pelvic floor musculature. These can be picked up by either isolated or running sutures which will act as a hemostat.
A to Z Entries
Clare E. Milner in Functional Anatomy for Sport and Exercise, 2019
The pelvis is the junction between the trunk and the lower extremities. It supports the spine and rests on the lower limbs. The pelvis is strong and sturdy and is made up of four bones: the two hip bones, plus the sacrum and coccyx of the distal spine (Figure 18). The bones form a ring with a large aperture in the middle; in women, this aperture is the birth canal. The hip bones themselves are made up of three fused bones: the ilium, ischium, and pubis. The lumbar spine sits immediately on top of the sacrum and comprises five individual vertebrae. There are several differences in structure between the male and female pelvis. Most notably, the female pelvis has a wider and more rounded pubic arch.
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
For this study, the BN and posterior urethra appearance in the CUG was reported but not included in the analysis. The relationship between the proximal end of the bulbar urethra in relation to the pubic arch ‘pubis symphysis (PS) and pubic rami’ was assigned a location either in zone A or zone B (Figure 1). Zone A is located distal to an imaginary line extending from the lower border of PS to a point midway between the two ischial tuberosities. On the other hand, zone B is located proximal to that line. When the bulbar urethral end location is in zone A, we assume that the pelvic injury was more superficial, minimal dissection is expected and a better outcome is awaited. On the other hand, zone B lies deep in relation to the pubic arch; hence, the urethral injury is anticipated to be deep in the pelvis and extensive dissection is expected and that might be reflected in the complexity of the surgery and the outcome.
Comparing the pelvis of Tibetan and Chinese Han women in rural areas of China: two population-based studies using coarsened exact matching
Published in Journal of Obstetrics and Gynaecology, 2022
Xiaojing Fan, Zhongliang Zhou, Martyn Stewart, Duolao Wang, Xin Lan, Shaonong Dang, Hong Yan
The assessment of the pelvis was divided into size and shape, as size is driven by the absolute pelvic dimensions (IS, IC, EC and TO) and shape is represented by relative pelvic dimensions. As one of the pelvic shapes, contracted pelvis was the focus of more attention because of the influence on delivery. Based on the external pelvic dimensions, three types of contracted pelvis can be defined, flat pelvis, funnel shaped pelvis and generally contracted pelvis. Flat pelvis was defined where the EC of the pelvis is less than 18 cm, and generally contracted pelvis was defined as 2 cm smaller dimension than normal values for the four pelvic dimension measures. Due to missing measurements for the angle of the pubic arch, in this study, the funnel shaped pelvis was defined as only TO being less than 8 cm (Bansal et al. 2011; Meng 2012).
Can maternal hormones play a significant role in delivery mode?
Published in Journal of Obstetrics and Gynaecology, 2022
Christina Pappa, Fani Gkrozou, Evangelos Dimitriou, Orestis Tsonis, Aikaterini Kitsouli, Dimitrios Varvarousis, Vasileios Xydis, Minas Paschopoulos, Panagiotis Kitsoulis
Childbirth is a complex process that demands the orchestration of multiple factors such as the structure and alterations of the maternal pelvis, the resistance and the stiffness of maternal pelvic and perineal tissues, the maternal position during labour, the intensity of uterine contractility, labour analgesia as well as the foetal position and presentation (Barbera et al. 2009; Reitter et al. 2014; Brik et al. 2017). For that reason, the implementation of a functional, well informed biomechanical model of childbirth seems to be imperative in the near future. Such models could initially offer a better educational basis to clinicians through enhanced hands-on training and could be further used for tailored birth planning. Challenges for future research will be to develop a computerised system which will be supportive to clinical decision. Demographic variables of maternal and foetal characteristics, data deriving from studies on hormonal changes and data supporting predictive factors of successful vaginal delivery can be used to form the basis of such a system (Bademkiran et al. 2021; Katsura et al. 2021). Well established data on transabdominal and transperineal imaging traits of crucial pelvic structures such as the pubic symphysis, the pubic arch and the pelvic floor muscles during pregnancy and parturition can also be included (Yan et al. 2016; Jean Dit Gautier et al. 2018; Lapeer et al. 2019).