Contribution of imaging to the understanding of the female pelvic fasciae

Fascia: an illustrative problem in international terminology

As a result of international nomenclatures being in Latin, with the terms usually being undefined and translated into national vernacular languages, the same terms have been used in different ways in different countries. Fascia is an example of this, the limits of the meaning of the word differing in English-, French- and German-speaking countries. These differences are itemized in a comparative table. In 1989 the General Assembly of the International Federation of Associations of Anatomists [IFAA] created the Federative Committee on Anatomical Terminology [FCAT] with a remit to create a new terminology for the anatomical sciences with full democratic consultation with the member societies of IFAA. The draft recommendations of FCAT on fascia and the reasons for them are given. Problems associated with the use, or lack of use, of international terminologies are illustrated. For the advancement of medical knowledge and understanding, the cooperation of authors, editors and publishers in using the current terminology in the right way remains of critical importance. It is suggested that, after adopting a terminology, IFAA has a responsibility to arrange for technical back-up.

Ventral tethering of the vagina and its role in the kinetics of urethra and bladder-neck straining

Based on the principle that the urethra forms an integral part of the ventral wall of the vagina, the aim of this study was to determine the elements of fixation of this wall and their role in the maintenance of urethral statics during strain exertion. Eight dissections of the female pelvis were performed by a simultaneous high and low approach. The anatomic data were compared with a study of the kinetics of the urethra by dynamic MRI. The lower part of the ventral vaginal wall is tethered to the pubis and the ischiopubic rami by a complex mixed system containing elements of both suspension and support. These elements simultaneously allow a complex and asymmetric movement around the inferior border of the pubic symphysis and maintain urinary continence during straining.