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Pelvic Anatomy

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1. Gross and Histologic Anatomy of the Pelvic Ureter: Clinical Applications to Pelvic Surgery. (PubMed)

Gross and Histologic Anatomy of the Pelvic Ureter: Clinical Applications to Pelvic Surgery. To further evaluate relationships of the pelvic ureter to clinically relevant structures and to characterize the anatomy, histology, and nerve density of the distal ureter.In this observational cadaveric study, 35 female cadavers were examined, 30 by gross dissections and five microscopically. Ureter length and segments of pelvic ureter were measured. Closest distances between the ureter and clinically (...) relevant points were recorded. The distal pelvic ureter and surrounding parametrium were evaluated microscopically. Nerve density was analyzed using automated quantification of peripheral nerve immunostaining. Average measurements of nerve density in the anterior and posterior quadrants surrounding the ureter were statistically compared using a two-tailed t test. Descriptive statistics were used for analyses with distances reported as mean±SD (range).Gross dissections revealed ureter length of 26.3±1.4

2019 Obstetrics and Gynecology

2. Interactive Pelvic Anatomy Model: A Tool for Teaching Basic Pelvic Anatomy. (PubMed)

Interactive Pelvic Anatomy Model: A Tool for Teaching Basic Pelvic Anatomy. A knowledge deficit of pelvic anatomy has been noted in obstetrics and gynecology residents. In this article, we introduce an innovative anatomic model that uses readily accessible and reusable materials to simulate and teach anatomic relationships in the female pelvis.Our anatomic model is a reusable and cost-effective modification of an existing pelvic model. We used felt fabric pieces with hook-and-loop fasteners (...) to simulate the pelvic floor, perineum, and surrounding musculature as they attach to corresponding sites on a standard bony pelvis. Our design incorporates the relationship of the ureter and major blood vessels in the pelvis by using yarn and ribbon. By allowing the student to build the anatomy of the pelvis piece by piece, the model provides the student a hands-on illustration of anatomic relationships in three dimensions.At our institution, both learners and faculty have positively evaluated our model

2017 Obstetrics and Gynecology

3. Female Pelvic Floor Immersive Simulation: A Randomized Trial to Test the Effectiveness of a Virtual Reality Anatomic Model on Resident Knowledge of Female Pelvic Anatomy. (PubMed)

Female Pelvic Floor Immersive Simulation: A Randomized Trial to Test the Effectiveness of a Virtual Reality Anatomic Model on Resident Knowledge of Female Pelvic Anatomy. To estimate the effect of a virtual reality (VR) anatomic model (VisCubeSX; VisBox, Inc., Saint Joseph, IL) on obstetrics and gynecology residents' knowledge of female pelvic floor anatomy compared with a traditional curriculum.Randomized controlled trial (Canadian Task Force classification I).Academic obstetrics (...) and gynecology resident training program.Traditional independent study curriculum versus traditional curriculum and VisCubeSX VR curriculum MEASUREMENTS AND MAIN RESULTS: Residents were randomized, stratified by year of training, in a 1:1 fashion to traditional independent study curriculum for pelvic anatomy versus traditional curriculum and the VisCubeSX VR anatomic model. Tests were administered to assess baseline and postintervention knowledge. A postintervention assessment of the VisCubeSX VR anatomic

2018 Journal of minimally invasive gynecology

4. Cervical cancer complicating pelvic organ prolapse, and use of a pessary to restore anatomy for optimal radiation: A case report (PubMed)

Cervical cancer complicating pelvic organ prolapse, and use of a pessary to restore anatomy for optimal radiation: A case report Cervical cancer is the most common gynecologic malignancy worldwide and the third most common gynecologic cancer in the USA. Improved screening methods such as liquid-based cytology accompanied by Human Papilloma Virus (HPV) co-testing have contributed to a declining incidence of cervical cancer. There are approximately 13,000 new cases per year in the United States (...) , accounting for 4200 deaths (Siegel et al., 2011). Pelvic organ prolapse increases with age, obesity and parity. In the absence of bothersome urinary, gastrointestinal or pressure symptoms, patients may choose conservative management options. The index patient was a 72 year old woman with a known history of pelvic organ prolapse who had been managed by her primary physician for 7 years until she developed new-onset vaginal bleeding. One month following worsening prolapse and increased vaginal bleeding she

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2018 Gynecologic Oncology Reports

5. Laparoscopic surgical anatomy for pelvic floor surgery. (PubMed)

Laparoscopic surgical anatomy for pelvic floor surgery. Understanding anatomy is one of the pillars for performing a safe, effective, and efficient surgery, but recently, it is reported that there has been a decline in teaching anatomy during the preclinical years of medical school. There is also evidence that by the time a medical student becomes a clinician, a considerable proportion of the basic anatomy knowledge is lost. Hence, it is crucial for surgeons performing or assisting in pelvic (...) floor surgery to revisit this integral clinical aspect of pelvic anatomy for performing a safe surgery. Pelvic organ prolapse repair, especially abdominal laparoscopic sacrocolpopexy, which is the gold standard of pelvic organ prolapse repair, presents a significant challenge to surgeons because the technique requires thorough and meticulous negotiation through abdomino-pelvic vascular structures and nerves supplying the pelvis, rectum, and ureters. The abdominal laparoscopic sacrocolpopexy surgery

2018 Best practice & research. Clinical obstetrics & gynaecology

6. A study on uterine lymphatic anatomy for standardization of pelvic sentinel lymph node detection in endometrial cancer. (PubMed)

A study on uterine lymphatic anatomy for standardization of pelvic sentinel lymph node detection in endometrial cancer. To describe the anatomy of uterine lymphatic drainage following cervical or fundal tracer injection to enable standardization of a pelvic sentinel lymph node (SLN) concept in endometrial cancer (EC).A prospective consecutive study of women with EC was conducted. A fluorescent dye (Indocyanine green) was injected into the cervix (n=60) or the uterine fundus (n=30). A systematic (...) of at least one pelvic pathway following cervical and fundal injection occurred in 98% and 80% respectively (p=0.005). Bilateral display of both pelvic pathways occurred in 30% and 20% respectively (p=0.6) as the LPP was less often displayed. Nearly one third of the 19% node positive patients had metastases along the LPP. No false negative SLNs were identified.Based on uterine lymphatic anatomy a bilateral detection of at least one SLN in both the UPP and LPP should be aimed for. Absence of display

2017 Gynecologic Oncology

7. Three-dimensional Study on the Structural Destruction of Pelvic Anatomy in Cervical Cancer

Three-dimensional Study on the Structural Destruction of Pelvic Anatomy in Cervical Cancer Three-dimensional Study on the Structural Destruction of Pelvic Anatomy in Cervical Cancer - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more (...) studies before adding more. Three-dimensional Study on the Structural Destruction of Pelvic Anatomy in Cervical Cancer The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03155529 Recruitment Status : Recruiting First Posted

2017 Clinical Trials

8. Retroperitoneal anatomy during excision of pelvic side wall endometriosis (PubMed)

Retroperitoneal anatomy during excision of pelvic side wall endometriosis Surgical management of endometriosis has been shown to improve dysmenorrhea at all disease stages and is recommended in severe disease for treatment of infertility. Deeply infiltrating endometriosis (DIE) produces thick inflammatory tissue that precludes visualization of anatomical landmarks and distorts normal anatomy. Excision of DIE poses several technical and surgical challenges that mandate a clear understanding (...) of the anatomy of the pelvic sidewall. This review details relevant surgical anatomy and addresses the principles of safe retroperitoneal entry, ureterolysis and excision of endometriotic lesions. Proper use of these techniques should facilitate safe and successful surgery for management of DIE.

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2016 Journal of Endometriosis and Pelvic Pain Disorders

9. Pelvic Anatomy

Pelvic Anatomy Pelvic Anatomy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Pelvic Anatomy Pelvic Anatomy Aka: Pelvic Anatomy (...) , Pelvis II. Anatomy Inguinal Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) Pelvis Lewis (1918) Gray's Anatomy 20th ed (in at or ) Lewis (1918) Gray's Anatomy 20th ed (in at or ) Perineum Lewis (1918) Gray's Anatomy 20th ed (in at or ) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Pelvic

2018 FP Notebook

10. What's new in the functional anatomy of pelvic organ prolapse? (PubMed)

What's new in the functional anatomy of pelvic organ prolapse? Provide an evidence-based review of pelvic floor functional anatomy related to pelvic organ prolapse.Pelvic organ support depends on interactions between the levator ani muscle and pelvic connective tissues. Muscle failure exposes the vaginal wall to a pressure differential producing abnormal tension on the attachments of the pelvic organs to the pelvic sidewall. Birth-induced injury to the pubococcygeal portion of the levator ani (...) muscle is seen in 55% of women with prolapse and 16% of women with normal support. Failure of the lateral connective tissue attachments between the uterus and vagina to the pelvic wall (cardinal, uterosacral, and paravaginal) are strongly related with prolapse (effect sizes ∼2.5) and are also highly correlated with one another (r ∼ 0.85). Small differences exist with prolapse in factors involving the vaginal wall length and width (effect sizes ∼1). The primary difference in ligament properties

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2016 Current Opinion in Obstetrics and Gynecology

11. Interobserver agreement of multicompartment ultrasound in the assessment of pelvic floor anatomy (PubMed)

Interobserver agreement of multicompartment ultrasound in the assessment of pelvic floor anatomy To assess the interobserver agreement of pelvic floor anatomical measurements using multicompartment pelvic floor ultrasound.Females were recruited from the urogynaecology/gynaecology clinics between July and October 2009 and underwent multicompartment pelvic floor ultrasonography (PFUS) using two-dimensional (2D) transperineal ultrasound (TPUS), high-frequency 2D/three-dimensional (3D) endovaginal (...) and Bland-Altman plots were created to demonstrate the agreement between the researchers. There was also a good-to-excellent agreement between the two clinicians for the assessment of pelvic organ prolapse (POP) in the anterior, middle and posterior compartment.Multicompartment PFUS is a reliable tool in the anatomical assessment of pelvic floor measurements and POP.We found a good-to-excellent agreement between the two assessors in the assessment of pelvic floor measurements for all three pelvic floor

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2016 The British journal of radiology

12. Unilateral Pelvic Side-Wall Lymph Node Resection for Rectal Cancer: A Review of the Anatomy. (PubMed)

Unilateral Pelvic Side-Wall Lymph Node Resection for Rectal Cancer: A Review of the Anatomy. The aim of this video is to highlight key safety and critical techniques employed during laparoscopic pelvic side-wall lymph node resection for rectal cancer. In addition, a review of the key pelvic side-wall anatomical structures will be included.We report a case of a 50-year-old Chinese female who presented with per-rectal bleeding, with colonoscopy revealing a 1.5 cm moderately differentiated rectal (...) adenocarcinoma 4 cm above the anorectal junction. Initial staging scans did not reveal any pelvic lymphadenopathy or distant metastasis and the patient underwent laparoscopic ultra-low anterior resection with concurrent total hysterectomy, bilateral salpingo-oophorectomy and natural orifice specimen extraction (NOTES) with defunctioning ileostomy. Final histology confirmed the diagnosis of moderately differentiated adenocarcinoma classified as pT1N0, resection R0. Subsequent follow-up detected a serial

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2016 Annals of Surgical Oncology

13. The Effect of Perineal Lacerations on Pelvic Floor Function and Anatomy at 6 Months Postpartum in a Prospective Cohort of Nulliparous Women. (PubMed)

The Effect of Perineal Lacerations on Pelvic Floor Function and Anatomy at 6 Months Postpartum in a Prospective Cohort of Nulliparous Women. To determine the effect of perineal lacerations on pelvic floor outcomes, including urinary and anal incontinence, sexual function, and perineal pain in a nulliparous cohort with low incidence of episiotomy.Nulliparous women were prospectively recruited from a midwifery practice. Pelvic floor symptoms were assessed with validated questionnaires, physical (...) was not associated with urinary or fecal incontinence, decreased sexual activity, perineal pain, or pelvic organ prolapse. Women with trauma had similar rates of sexual activity; however, they had slightly lower sexual function scores (27.3 vs 29.1). Objective measures of pelvic floor strength, rectal tone, urinary incontinence, and perineal anatomy were equivalent. The subgroup of women with deeper (> 2 centimeter) perineal trauma demonstrated increased likelihood of perineal pain (15.5% vs 6.2%) and weaker

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2016 Birth

14. Complete evaluation of anatomy and morphology of the infertile patient in a single visit; the modern infertility pelvic ultrasound examination. (PubMed)

Complete evaluation of anatomy and morphology of the infertile patient in a single visit; the modern infertility pelvic ultrasound examination. The comprehensive "one-stop shop" ultrasound evaluation of an infertile woman, performed around cycle days 5 to 9, will reveal abundant information about the anatomy and morphology of the pelvic organs and thereby avoid costly radiation and iodinated contrast exposure. We propose a two-dimensional and three-dimensional ultrasound to examine

2016 Fertility and Sterility

15. Chronic Pelvic Pain

colpopexy: management of postoperative pudendal nerve entrapment. Obstet Gynecol, 1996. 88: 713. 218. Fisher, H.W., et al. Nerve injury locations during retropubic sling procedures. Int Urogynecol J, 2011. 22: 439. 219. Moszkowicz, D., et al. Where does pelvic nerve injury occur during rectal surgery for cancer? Colorectal Dis, 2011. 13: 1326. 220. Ashton-Miller, J.A., et al. Functional anatomy of the female pelvic floor. Ann N Y Acad Sci, 2007. 1101: 266. 221. Amarenco, G., et al. [Perineal neuropathy (...) Chronic Pelvic Pain Chronic Pelvic Pain | Uroweb › Chronic Pelvic Pain Chronic Pelvic Pain To access the pdfs & translations of individual guidelines, please as EAU member. Non-EAU members can view the web versions. To become an EAU member, click . D. Engeler (Chair), A.P. Baranowski, B. Berghmans, J. Borovicka, A.M. Cottrell, P.S. Elneil, J. Hughes, E. Messelink (Vice-chair), A.C. de C Williams Guidelines Associates: L. Pacheco-Figueiredo, B. Parsons, S. Goonewardene TABLE OF CONTENTS

2019 European Association of Urology

16. Essential Anatomy of the Anorectum for Colorectal Surgeons Focused on the Gross Anatomy and Histologic Findings (PubMed)

fascial plane. With the development of pelvic structure anatomy, we can understand better how we can remove the tumor and the surrounding metastatic lymph nodes without damaging the neural structure. However, because the anorectal anatomy is not yet fully understood, we hope that additional studies of anatomy will enable anorectal surgery to be performed based on complete anatomical knowledge. (...) Essential Anatomy of the Anorectum for Colorectal Surgeons Focused on the Gross Anatomy and Histologic Findings The anorectum is a region with a very complex structure, and surgery for benign or malignant disease of the anorectum is impossible without accurate anatomical knowledge. The conjoined longitudinal muscle consists of smooth muscle from the longitudinal muscle of the rectum and the striate muscle from the levator ani and helps maintain continence; the rectourethralis muscle

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2018 Annals of coloproctology

17. Postmenopausal Subacute or Chronic Pelvic Pain

as the initial or primary imaging examination for evaluation of pelvic pain localized to the perineum, vulva, or vagina, particularly when the physical examination is normal. However, there is emerging evidence to support the first- line utility of MRI when endometriosis or fistulizing disease are suspected [34]; readers are again referred to specific ACR Appropriateness Criteria guidelines for these clinical scenarios (see Appendix 1). MRI also enables accurate depiction of pelvic floor muscular anatomy (...) Frequency and Pelvic Pain Due to Postoperative Uterine Adhesions. WMJ 2016;115:43-5. 18. Ignacio EA, Dua R, Sarin S, et al. Pelvic congestion syndrome: diagnosis and treatment. Semin Intervent Radiol 2008;25:361-8. 19. Karaosmanoglu D, Karcaaltincaba M, Karcaaltincaba D, Akata D, Ozmen M. MDCT of the ovarian vein: normal anatomy and pathology. AJR Am J Roentgenol 2009;192:295-9. 20. Koc Z, Ulusan S, Oguzkurt L. Right ovarian vein drainage variant: is there a relationship with pelvic varices? Eur J

2018 American College of Radiology

18. The Utility of and Indications for Routine Pelvic Examination

are needed. Potential Benefits of the Screening Pelvic Examination for Asymptomatic Women Based on expert opinion, potential benefits of the pelvic examination include early detection of treatable gynecologic conditions before symptoms occurring (eg, vulvar or vaginal cancer), as well as incidental findings such as dermatologic changes and foreign bodies. Additionally, screening pelvic examinations in the context of a well-woman visit ( ) may allow gynecologists to explain a patient’s anatomy, reassure (...) The Utility of and Indications for Routine Pelvic Examination The Utility of and Indications for Routine Pelvic Examination - ACOG Menu ▼ The Utility of and Indications for Routine Pelvic Examination Page Navigation ▼ Number 754 Committee on Gynecologic Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice in collaboration with committee members Catherine Cansino, MD, MPH and Lubna Chohan, MD. This information

2018 American College of Obstetricians and Gynecologists

19. The improvement in pelvic floor symptoms with weight loss in obese women does not correlate with the changes in pelvic anatomy. (PubMed)

The improvement in pelvic floor symptoms with weight loss in obese women does not correlate with the changes in pelvic anatomy. It has been suggested that weight reduction decreases the frequency of urinary incontinence (UI) episodes. However, it is not known if this improvement is associated with anatomical changes in the pelvis. The aim of this study was to investigate the effects of weight loss on UI episodes and pelvic floor anatomy.Three hundred seventy-eight overweight/obese women were (...) randomly allocated either to behavioral weight loss or to structured education programs. The patients were evaluated by voiding diary, Pelvic Floor Distress Inventory (PFDI), and Pelvic Organ Prolapse Quantification (POP-Q) system at baseline and after 6 months.The women in the intervention group had a mean weight loss of 9.4 %, whereas the weight in the control group remained almost the same (P < 0.001). While there were no change in stress and urge incontinence episodes in the control group, the mean

2014 International urogynecology journal

20. Internal Validation of the Renal Pelvic Score: A Novel Marker of Renal Pelvic Anatomy That Predicts Urine Leak After Partial Nephrectomy. (PubMed)

Internal Validation of the Renal Pelvic Score: A Novel Marker of Renal Pelvic Anatomy That Predicts Urine Leak After Partial Nephrectomy. To internally validate the renal pelvic score (RPS) in an expanded cohort of patients undergoing partial nephrectomy (PN).Our prospective institutional renal cell carcinoma database was used to identify all patients undergoing PN for localized renal cell carcinoma from 2007 to 2013. Patients were classified by RPS as having an intraparenchymal (...) . Seventy-two of 831 renal pelvises (8.7%) were classified as intraparenchymal. Intrarenal pelvic anatomy was associated with a markedly increased risk of urine leak (43.1% vs 3.0%; P <.001), major urine leak requiring intervention (23.6% vs 1.7%; P <.001), and minor urine leak (19.4% vs 1.2%; P <.001) compared with that in patients with an extrarenal pelvis. After multivariate adjustment, RPS (intraparenchymal renal pelvis; odds ratio [OR], 24.8; confidence interval [CI], 11.5-53.4; P <.001

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2014 Urology

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