The anatomical components of urinary continence
Christian Wallner1, Noshir F Dabhoiwala, Marco C DeRuiter
1Department of Anatomy, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
European Urology
|August 30, 2008
Summary
The female external urethral sphincter (EUS) attaches to the levator ani muscle (LAM) via a tendinous connection, crucial for urinary continence. This anatomical link highlights the LAM
Area of Science:
- Pelvic floor anatomy
- Urogynecology
- Female reproductive anatomy
Background:
- The levator ani muscle (LAM) is vital for urinary continence.
- The precise anatomical relationship between the LAM and the external urethral sphincter (EUS) is not fully understood.
Purpose of the Study:
- To clarify the topographical relationship between the EUS and the LAM.
Main Methods:
- Studied serial sections of fetal pelves (10-27 weeks gestation) from 11 females and 9 males.
- Used histochemical and immunohistochemical staining for muscle tissues.
- Created 3D reconstructions and qualitatively evaluated anatomy.
Main Results:
- The EUS lacks direct bony attachment.
- In females, the inferior EUS is tendinously connected to the LAM.
- This connection facilitates urethral closure during simultaneous contraction of EUS and LAM.
Conclusions:
- Female EUS is anchored to the LAM by a tendinous connection.
- EUS function relies on the integrity of the LAM and its pelvic wall attachments.
- A similar EUS-LAM attachment was not observed in males.
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