{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T18:17:40Z","timestamp":1783707460284,"version":"3.55.0"},"reference-count":79,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,16]],"date-time":"2017-03-16T00:00:00Z","timestamp":1489622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81100480"],"award-info":[{"award-number":["81100480"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Anatomy"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The pelvic floor guards the passage of the pelvic organs to the exterior. The near\u2010epidemic prevalence of incontinence in women continues to generate interest in the functional anatomy of the pelvic floor. However, due to its complex architecture and poor accessibility, the classical \u2018dissectional\u2019 approach has been unable to come up with a satisfactory description, so that many aspects of its anatomy continue to raise debate. For this reason, we opted for a \u2018sectional\u2019 approach, using the Chinese Visible Human project (four females, 21\u201335\u00a0years) and the Visible Human Project (<jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>; one female, 59\u00a0years) datasets to investigate age\u2010related changes in the architecture of the anterior and middle compartments of the pelvic floor. The puborectal component of the levator ani muscle defined the levator hiatus boundary. The urethral sphincter complex consisted of a circular proximal portion (urethral sphincter proper), a sling that passed on the vaginal wall laterally to attach to the puborectal muscle (urethral compressor), and a circular portion that surrounded the distal urethra and vagina (urethrovaginal sphincter). The exclusive attachment of the urethral sphincter to soft tissues implies dependence on pelvic\u2010floor integrity for optimal function. The vagina was circular at the introitus and gradually flattened between bladder and rectum. Well\u2010developed fibrous tissue connected the inferior vaginal wall with urethra, rectum and pelvic floor. With eight\u2010muscle insertions, the perineal body was a strong, irregular fibrous node that guarded the levator hiatus. Only loose areolar tissue comprising a remarkably well developed venous plexus connecting the middle and superior parts of the vagina with the lateral pelvic wall. The posterolateral boundary of the putative cardinal and sacrouterine ligaments coincided with the adventitia surrounding the mesorectum. The major difference between the young\u2010adult and postmenopausal pelvic floor was the expansion of fat in between the components of the pelvic floor. We hypothesize that accumulation of pelvic fat compromises pelvic\u2010floor cohesion, because the pre\u2010pubertal pelvis contains very little fibrous and adipose tissue, and fat is an excellent lubricant.<\/jats:p>","DOI":"10.1111\/joa.12598","type":"journal-article","created":{"date-parts":[[2017,3,16]],"date-time":"2017-03-16T08:24:38Z","timestamp":1489652678000},"page":"651-663","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Architectural differences in the anterior and middle compartments of the pelvic floor of young\u2010adult and postmenopausal females"],"prefix":"10.1111","volume":"230","author":[{"given":"Yi","family":"Wu","sequence":"first","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research Academic Medical Center University of Amsterdam Amsterdam The Netherlands"},{"name":"Institute of Computing Medicine Biomedical Engineering College Third Military Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noshir F.","family":"Dabhoiwala","sequence":"additional","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaco","family":"Hagoort","sequence":"additional","affiliation":[{"name":"Department of Anatomy &amp; Embryology Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Wen","family":"Tan","sequence":"additional","affiliation":[{"name":"Institute of Computing Medicine Biomedical Engineering College Third Military Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao\u2010Xiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute of Computing Medicine Biomedical Engineering College Third Military Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter H.","family":"Lamers","sequence":"additional","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.10215"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01800624"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-194007000-00016"},{"key":"e_1_2_8_5_1","first-page":"677","article-title":"Histologic study of the pelvic connective tissue","volume":"97","author":"Berglas B","year":"1953","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1242\/dev.051086"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(01)01346-1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.01.022"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(50)90334-6"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2439-1"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-012-1801-4"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01895101"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)63025-8"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.02.021"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-012-1842-8"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-012-0945-8"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)62764-2"},{"key":"e_1_2_8_18_1","first-page":"91","article-title":"Correlative study of paraurethral anatomy","volume":"68","author":"DeLancey JO","year":"1986","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_19_1","first-page":"296","article-title":"Structural aspects of the extrinsic continence mechanism","volume":"72","author":"DeLancey JO","year":"1988","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(92)91562-O"},{"key":"e_1_2_8_21_1","first-page":"765","article-title":"Histology of the connection between the vagina and levator ani muscles. 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