Recommended standardized anatomic terminology of the posterior female pelvis and vulva based on a structured medical literature review

Audra Jolyn Hill, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT. Electronic address: jolyn.hill@hsc.utah.edu.
Sunil Balgobin, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX.
Kavita Mishra, Stanford Health Care, Stanford University, Palo Alto, CA.
Peter C. Jeppson, Division of Urogynecology, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM.
Thomas Wheeler, Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, Greenville, SC.
Donna Mazloomdoost, Department of Obstetrics and Gynecology, Mid-Atlantic Urogynecology and Pelvic Surgery, Annadale, VA.
Mallika Anand, Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA.
Cara Ninivaggio, Division of Urogynecology, University of New Mexico, Albuquerque, NM.
Jennifer Hamner, Indiana University, Indianapolis, IN.
Katarzyna Bochenska, Advocate Aurora HealthFollow
Saifuddin T. Mama, Department of Obstetrics and Gynecology, Cooper Medical School of Rowan University, Camden, NJ.
Ethan M. Balk, Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island.
Marlene M. Corton, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX.
John Delancey, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.

Abstract

Background: Anatomic terminology in both written and verbal forms has been shown to be inaccurate and imprecise.

Objective: Here, we aimed to (1) review published anatomic terminology as it relates to the posterior female pelvis, posterior vagina, and vulva; (2) compare these terms to "Terminologia Anatomica," the internationally standardized terminology; and (3) compile standardized anatomic terms for improved communication and understanding.

Study design: From inception of the study to April 6, 2018, MEDLINE database was used to search for 40 terms relevant to the posterior female pelvis and vulvar anatomy. Furthermore, 11 investigators reviewed identified abstracts and selected those reporting on posterior female pelvic and vulvar anatomy for full-text review. In addition, 11 textbook chapters were included in the study. Definitions of all pertinent anatomic terms were extracted for review.

Results: Overall, 486 anatomic terms were identified describing the vulva and posterior female pelvic anatomy, including the posterior vagina. "Terminologia Anatomica" has previously accepted 186 of these terms. Based on this literature review, we proposed the adoption of 11 new standardized anatomic terms, including 6 regional terms (anal sphincter complex, anorectum, genital-crural fold, interlabial sulcus, posterior vaginal compartment, and sacrospinous-coccygeus complex), 4 structural terms (greater vestibular duct, anal cushions, nerve to the levator ani, and labial fat pad), and 1 anatomic space (deep postanal space). In addition, the currently accepted term rectovaginal fascia or septum was identified as controversial and requires further research and definition before continued acceptance or rejection in medical communication.

Conclusion: This study highlighted the variability in the anatomic nomenclature used in describing the posterior female pelvis and vulva. Therefore, we recommended the use of standardized terminology to improve communication and education across medical and anatomic disciplines.

Type

Article

PubMed ID

33705749

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