Interactive three‐dimensional teaching models of the female and male pelvic floor

Abstract

Controversies regarding structure and function of the pelvic floor persist because of its poor accessibility and complex anatomical architecture. Most data are based on dissection. This "surgical" approach requires profound prior knowledge, because applying the scalpel precludes a "second look." The "sectional" approach does not entail these limitations, but requires segmentation of structures and threedimensional reconstruction. This approach has produced several "Visible Human Projects." We dealt with limited spatial resolution and difficult-to-segment structures by proceeding from clear-cut to more fuzzy boundaries and comparing segmentation between investigators. We observed that the bicipital levator ani muscle consisted of pubovisceral and puborectal portions; that the pubovisceral muscle formed, together with rectococcygeal and rectoperineal muscles, a rectal diaphragm; that the external anal sphincter consisted of its subcutaneous portion and the puborectal muscle only; that the striated urethral sphincter had three parts, of which the middle (urethral compressor) was best developed in females and the circular lower ("membranous") best in males; that the rectourethral muscle, an anterior extension of the rectal longitudinal smooth muscle, developed a fibrous node in its center (perineal body); that the perineal body was much better developed in females than males, so that the rectourethral subdivision into posterior rectoperineal and anterior deep perineal muscles was more obvious in females; that the superficial transverse perineal muscle attached to the fibrous septa of the ischioanal fat; and that the uterosacral ligaments and mesorectal fascia colocalized. To facilitate comprehension of the modified topography we provide interactive 3D-PDFs that are freely available for teaching purposes.

Incontinencia severa por lesión del esfinter externo durante resección transuretral de próstata

“…In order to measure the forward displacement of the prostatic urethra and bladder neck due to the enlargement of the RU of the CZ, we would need the MRI images with ERC. However, there are anatomical references of the MRI that may correlate to those of the transperineal ultrasound (TPU), documenting the deviation of the PU and bladder neck due to RU prostatic enlargement through the pubocervical angle, considering that the urogenital diaphragm is not perpendicular to the US 14 , but it is to the major axis of the pubis, demonstrated in the sagittal images of the masculine pelvis by TPU, MRI, images of threedimensional anatomical models of fetuses and cadavers [14][15][16][17][18][19] .…”

Most Integrated Virtual Images of the Bones in the Teaching of Human Anatomy: Are There Any Differences Between Online and on-Site Tutor?

“…Different active learning strategies are increasingly utilized in the new and updated digital formats (Chen, Ayoob, Desser, & Khurana, 2021). Medical students appreciate the opportunity to use new interactive models (Wu et al, 2020) or 3D-printed models (Kazoka, Pilmane, & Edelmers, 2021).…”

Childbirth Computational Models: Characteristics and Applications

“…Nonetheless, fetuses are mostly "floating" in open space above the maternal pelvis in existing models, due to the lack of maternal soft tissues. Despite the fact that geometrical models of maternal pelvic floor and pelvic organs have been developed in numerous studies [76][77][78][79][80][81], childbirth computational models rarely include structures other than levator ani muscles. This leads to inaccurate estimations of the resistive force that the fetal model experiences and requires an imposed trajectory and movements to obtain stable fetal passage through the pelvis.…”