Urogenital diaphragm

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Urogenital diaphragm
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Coronal section of anterior part of pelvis, through the pubic arch. Seen from in front.
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Vertical section of bladder, penis, and urethra.
Details
Artery Branches of internal pudendal artery
Vein Branches of internal pudendal veins
Nerve Branches of perineal nerve
Identifiers
Latin diaphragma urogenitale
Anatomical terminology

Older texts have asserted the existence of a urogenital diaphragm, also called the triangular ligament, which was described as a layer of the pelvis that separates the deep perineal sac from the upper pelvis, lying between the inferior fascia of the urogenital diaphragm (perineal membrane) and superior fascia of the urogenital diaphragm.

While this term is used to refer to a layer of the pelvis that separates the deep perineal sac from the upper pelvis, such a discrete border of the sac probably does not exist. [1] [2] [3] [4] [5]

While it has no official entry in Terminologia Anatomica, the term is still used occasionally to describe the muscular components of the deep perineal pouch. The urethra and the vagina, though part of the pouch, are usually said to be passing through the urogenital diaphragm, rather than part of the diaphragm itself. [2]

Some researchers still assert that such a diaphragm exists, [6] and the term is still used in the literature. [7]

The urethral diaphragm is an anatomic landmark used in radiologic and urologic classification of urethral injury. Specifically, when a retrograde urethrogram demonstrates extension of contrast from the proximal bulbous urethra into the perineum, there is an increase of grading of the injury from a Type 2 to a Type 3 classification.

The term "urogenital diaphragm" is often confused with the pelvic diaphragm (pelvic floor), which is a true diaphragm supporting many of the pelvic organs. [8]

Related Research Articles

<span class="mw-page-title-main">Urethra</span> Tube that connects the urinary bladder to the external urethral orifice

The urethra is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra connects to the urinary meatus above the vagina, whereas in marsupials, the female's urethra empties into the urogenital sinus.

<span class="mw-page-title-main">Perineum</span> Region of the body including the perineal body and surrounding structures

The perineum in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. The perineum is the region of the body between the pubic symphysis and the coccyx, including the perineal body and surrounding structures. There is some variability in how the boundaries are defined. The perineal raphe is visible and pronounced to varying degrees. The perineum is an erogenous zone. This area is known as the taint or chode in American slang.

<span class="mw-page-title-main">Pudendal nerve</span> Main nerve of the perineum

The pudendal nerve is the main nerve of the perineum. It is a mixed nerve and also conveys sympathetic autonomic fibers. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well as the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter.

<span class="mw-page-title-main">Bulbourethral gland</span> Gland in males to help with sperm health

The bulbourethral glands or Cowper's glands are two small exocrine glands in the reproductive system of many male mammals. They are homologous to Bartholin's glands in females. The bulbourethral glands are responsible for producing a pre-ejaculate fluid called Cowper's fluid, which is secreted during sexual arousal, neutralizing the acidity of the urethra in preparation for the passage of sperm cells.

<span class="mw-page-title-main">Levator ani</span> Broad, thin muscle group, situated on either side of the pelvis

The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis.

<span class="mw-page-title-main">Bulbospongiosus muscle</span> Superficial muscle of the perineum

The bulbospongiosus muscle is one of the superficial muscles of the perineum. It has a slightly different origin, insertion and function in males and females. In males, it covers the bulb of the penis. In females, it covers the vestibular bulb.

<span class="mw-page-title-main">Pelvic floor</span> Anatomical structure

The pelvic floor or pelvic diaphragm is an anatomical location in the human body, which has an important rule in urinary and anal continence, sexual function and support of the pelvic organs. muscular partition separating the pelvic cavity (above), and perineal region (below). It is formed by the levator ani muscle and coccygeus muscle, and associated connective tissue.

<span class="mw-page-title-main">Onuf's nucleus</span> Group of neurons

Onuf's nucleus is a distinct group of neurons located in the ventral part of the anterior horn of the sacral region of the human spinal cord involved in the maintenance of micturition and defecatory continence, as well as muscular contraction during orgasm. It contains motor neurons, and is the origin of the pudendal nerve. The sacral region of the spinal cord is the fourth segment of vertebrae in the spinal cord which consists of the vertebrae 26-30. While working in New York City in 1899, Bronislaw Onuf-Onufrowicz discovered this group of unique cells and originally identified it as “Group X.” “Group X” was considered distinct by Onufrowicz because the cells were different in size from the surrounding neurons in the anterolateral group, suggesting that they were independent.

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<span class="mw-page-title-main">External sphincter muscle of male urethra</span>

The external sphincter muscle of male urethra, also sphincter urethrae membranaceae, sphincter urethrae externus, surrounds the whole length of the membranous urethra, and is enclosed in the fascia of the urogenital diaphragm.

<span class="mw-page-title-main">Stress incontinence</span> Form of urinary incontinence from an inadequate closer of the bladdertae

Stress incontinence, also known as stress urinary incontinence (SUI) or effort incontinence is a form of urinary incontinence. It is due to inadequate closure of the bladder outlet by the urethral sphincter.

<span class="mw-page-title-main">Transverse perineal muscles</span>

The transverse perineal muscles are the superficial and the deep transverse perineal muscles.

<span class="mw-page-title-main">Perineal membrane</span> Anatomical term

The perineal membrane is an anatomical term for a fibrous membrane in the perineum. The term "inferior fascia of urogenital diaphragm", used in older texts, is considered equivalent to the perineal membrane.

<span class="mw-page-title-main">Superficial perineal pouch</span>

The superficial perineal pouch is a compartment of the perineum.

<span class="mw-page-title-main">Deep perineal pouch</span> Anatomic space enclosed partly by the perineum

The deep perineal pouch is the anatomic space enclosed in part by the perineum, and located superior to the perineal membrane.

<span class="mw-page-title-main">Membranous urethra</span> Narrowest part of the urethra

The membranous urethra or intermediate part of male urethra is the shortest, least dilatable, and, with the exception of the urinary meatus, the narrowest part of the urethra.

<span class="mw-page-title-main">Superior fascia of the urogenital diaphragm</span>

The superior fascia of the urogenital diaphragm is continuous with the obturator fascia and stretches across the pubic arch.

<span class="mw-page-title-main">Urethral sphincters</span> Muscles keeping urine in the bladder

The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the male or female external urethral sphincter and the internal urethral sphincter. When either of these muscles contracts, the urethra is sealed shut.

<span class="mw-page-title-main">Root of penis</span> Internal portion of the human penis

In human male anatomy, the radix or root of the penis is the internal and most proximal portion of the human penis that lies in the perineum. Unlike the pendulous body of the penis which is suspended from the pubic symphysis, the root is attached to the pubic arch of the pelvis and is not visible externally. It is triradiate in form, consisting of three masses of erectile tissue; the two diverging crura, one on either side, and the median bulb of the penis or urethral bulb. Approximately one third to one half of the penis is embedded in the pelvis and can be felt through the scrotum and in the perineum.

<span class="mw-page-title-main">Vaginal support structures</span> Structures that maintain the position of the vagina within the pelvic cavity

The vaginal support structures are those muscles, bones, ligaments, tendons, membranes and fascia, of the pelvic floor that maintain the position of the vagina within the pelvic cavity and allow the normal functioning of the vagina and other reproductive structures in the female. Defects or injuries to these support structures in the pelvic floor leads to pelvic organ prolapse. Anatomical and congenital variations of vaginal support structures can predispose a woman to further dysfunction and prolapse later in life. The urethra is part of the anterior wall of the vagina and damage to the support structures there can lead to incontinence and urinary retention.

References

  1. Kaye K, Milne N, Creed K, van der Werf B (1997). "The 'urogenital diaphragm', external urethral sphincter and radical prostatectomy". ANZ Journal of Surgery. 67 (1): 40–4. doi:10.1111/j.1445-2197.1997.tb01892.x. PMID   9033375.
  2. 1 2 "Chapter 38: The perineal region and external genitalia" . Retrieved 2007-12-09.
  3. Oelrich TM (1980). "The urethral sphincter muscle in the male" (PDF). Am. J. Anat. 158 (2): 229–46. doi:10.1002/aja.1001580211. hdl: 2027.42/49683 . PMID   7416058.
  4. Mirilas P, Skandalakis JE (2004). "Urogenital diaphragm: an erroneous concept casting its shadow over the sphincter urethrae and deep perineal space". J. Am. Coll. Surg. 198 (2): 279–90. doi:10.1016/j.jamcollsurg.2003.07.022. PMID   14759786.
  5. Dorschner W, Biesold M, Schmidt F, Stolzenburg JU (1999). "The dispute about the external sphincter and the urogenital diaphragm". J. Urol. 162 (6): 1942–5. doi:10.1016/S0022-5347(05)68074-3. PMID   10569543.
  6. Herschorn S (2004). "Female pelvic floor anatomy: the pelvic floor, supporting structures, and pelvic organs". Rev Urol. 6 Suppl 5: S2–S10. PMC   1472875 . PMID   16985905.
  7. Hruby S, Ebmer J, Dellon AL, Aszmann OC (2005). "Anatomy of pudendal nerve at urogenital diaphragm--new critical site for nerve entrapment". Urology. 66 (5): 949–52. doi:10.1016/j.urology.2005.05.032. PMID   16286101.
  8. Maclean, Allan; Reid, Wendy (2011). "40". In Shaw, Robert (ed.). Gynaecology. Edinburgh New York: Churchill Livingstone/Elsevier. pp. 599–612. ISBN   978-0-7020-3120-5; Access provided by the University of Pittsburgh{{cite book}}: CS1 maint: postscript (link)