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<P ALIGN=justify><FONT SIZE=2 COLOR="#000000" FACE="Verdana">
This basic view is very important for all the Perineologist because it shows the real in vivo anatomy of the pelvis.
<BR><BR>
In fact, the usual descriptions of this area are misleading for 2 reasons:
<BR>
<LI> first, the textbooks of anatomy depict the anatomy as seen during dissection; there is a downwards inclination of the posterior perineum corresponding to the anatomy found during defecation.
<LI>second, the posterior perineum is neglected and the anal canal is in direct contact with the sacro-coccygeal junction
<BR><BR>
These 2 errors have been corrected in our 3d view which corresponds to the images obtained using MRI in normal female patients.
<BR><BR>
To restore a normal anatomy, the perineologist surgeon must have some anatomical facts in mind; these facts are visible in our 3D view:
<BR><BR>
<LI>there is no part of the pubo-rectal or levator plate muscles between the vagina and the ano-rectum.
<LI>the pubo-rectal muscle is included in the top part of the anal sphincter.
<LI>the vagina is not rectilinear; there is an angle between its two parts.
<LI>this angle is induced by the disposition of the pelvic fascia and its extensions, the pubo-urethro-vaginal ligaments and the utero-sacral ligaments.
<LI>the pubo-rectal muscle and the levator plate help the fascia to maintain this vaginal angle, the urethro-vesical and the ano-rectal angle at rest.
<LI>the axis of the superior part of the vagina is oriented to S2-S3 and not to the promontori.
<LI>the coccyx is the butt hinge joint of the levator plate; it is moving during defecation or contraction of the pubo-rectal muscle.
<BR><BR>
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