임상의를 위한 여성 골반저의 해부학 : 여성 방광 및 요도와 골반 지지를 중심으로

Abstract

The female pelvic floor is an understudied region of the body in the aspect of physiologic and biomechanical perspective. The anatomic structures in the female that prevent incontinence and pelvic organ prolapse are important field to support sphincteric system and pelvic floor against increased daily abdominal activities. In the urethra, the action of the vesical neck and urethral sphincteric mechanisms maintains urethral closure. A supportive hammock under the urethra and vesical neck provides a firm backstop against which the urethra is compressed during increases in abdominal pressure. This supporting layer consists of the anterior vaginal wall and connective tissue that attaches it to the pelvic bones through the pubovaginal portion of the levator ani muscle, and the uterosacral and cardinal ligaments comprising the tendinous arch of the pelvic fascia. The endopelvic fascia plays an important role in pelvic floor supporting system and three support axes maintain the central portion of pelvic organs. No one structure is solely responsible for the proper functioning of this region.