The diagram illustrates anatomy of pelvic floor viewed from above. Ligaments of the pelvis support the vagina,cervix and pelvic organs. The ligaments include the Midurethral or Pubourethral ligament (PUL), the Arcus Tendineous (ATFP) and the Cardinal (CL) or Transverse Cervical ligaments and Uterosacral (USL) complex. The bladder rests on the Mid vaginal hammock (MVH). The uterus and cervix (CX) play a critical role in supporting the pelvic organs. Weakness or laxity of vaginal ligaments leads to prolapse and also prevents muscles from contracting effectively to open and close the urethra and anus. In the pelvis the muscles are not always attached directly to bone but transmit their forces indirectly via these ligaments.
Delivering Excellence and Specialised
Services in Safe Prolapse Surgery
|
procidentia (2)
|
|
|
procidentia with bladder and rectal prolapse serag youssif
|
|
|
procidentia (3)
|
|
|
enterocele with procidentia Serag Youssif
|
|
|
cystocele large Serag Youssif
|
|
|
cystocele large (Serag Youssif operating
|
|
The cervix and uterus are held in the pelvis to side pelvic bones by two Cardinal ligaments [CL], to back bone the sacrum by two Uterosacral ligaments [ USL ] and to pubic bone in front by Pubocervical facia [PCF]. The urethra is held to back of pubic bone by midurethral ligament.
Illustration by Dr. Serag Youssif
The lateral pelvic view shows how the vaginal tube is attached anteriorly to the symphysis pubis via the Pubourethral ligaments (PUL) and posteriorly to the sacrum via the uterosacral ligaments (USL).
Artwork by Dr Serag Youssif