Pelvic Floor Anatomy for the Urogynecologist-Pelvic Floor Anatomy for the Urogynecologist

Video Transcription

Video Summary

In this video, Drs. Carolyn Swenson and Anne Simarco discuss pelvic floor anatomy for urogynecologists. They focus on the anatomy that is most relevant to prolapse and do not cover urethral and anal sphincter anatomy. They provide a comprehensive understanding of level 3 support, functional anatomy, and clinical assessment of the levator ani muscles, level 1 apical support structures, and the relationship between level 1 and level 3 support. They discuss Delancey's levels of support, which include level 1 apical support, level 2 paravaginal support, and level 3 distal vaginal support. They explain the structures involved in level 3 support, such as the perineal membrane and levator ani muscles. They also discuss the function and muscle fiber direction of the levator ani muscles, as well as how to palpate and assess the pelvic floor muscles. They provide information on levator ani injury, levator ani defects in relation to prolapse, and the support provided by cardinal and uterosacral ligaments in level 1 support. They explain the characteristics and function of these ligaments, as well as their lengthening in prolapse. They conclude by emphasizing the strong correlation between level 1 and level 3 failure in prolapse, and the need to address both in repairs.

Asset Caption

Carolyn Swenson, MD, Associate Professor of Obstetrics & Gynecology, Division Chief of Urogynecology, University of Utah
Anne Sammarco, MD, MPH, Assistant Professor of Obstetrics & Gynecology, Case Western Reserve University

Keywords

pelvic floor anatomy

urogynecology

pelvic organ prolapse

levator ani muscles

Delancey levels of support

apical support

perineal membrane