Urethra

The male urethra is a muscular tube approximately 20 cm in length. The urethra in men extends from the neck of the bladder through the prostate gland (prostatic urethra) to the urogenital diaphragm of the perineum (membranous urethra), and then to the external opening of the glans (penile or spongy urethra) (Figure III-3-23).

The female urethra is approximately 4 cm in length and extends from the neck of the bladder to the external urethral orifice of the vulva (Figure III-3-24).

Ureter

Rectovesical pouch ^ (

Seminal vesicle -

Ejaculatory duct-

Clinical Corre ate

Hypertrophic Prostate Gland

An enlarged prostate gland will compress the urethra. The patient will complain of the

Urinary bladder urge to urinate often and has difficulty with starting

Ductus deferens urination.

Because the prostate gland is

Prostate gland endosed in a dense

Median lobe (M)

connective tissue capsule,

Anterior lobe (A)

hypertrophy will compress the

Posterior lobe (P)

prostatic portion of the urethra.

Urethra

Urogenital

Penis diaphragm

Bulbourethral

Figure 111-3-23. Male Pelvis

Oviduct

Ureter

Uterus

Suspensory ligament

Rectouterine

Round pouch(Pouch ligament of Douglas)

vesicouterine pouch

Urinary badder

Urethra

Clitoris

Urogenital diaphragm

Figure III-3-24. Female Pelvis

KAPLAIT._

PELVIC DIAPHRAGM

Pelvic and urogenital (UG) diaphragms are illustrated in Figure III-3-25.

Figure 111-3-25. Pelvic Diaphragm

Clinical Correlate

PELVIC FLOOR AND PERINEUM

In the male, injury to the bulb of the penis may result in extravasation of urine from the urethra into the superficial perineal space. From this space, urine may pass into the scrotum, into the penis, and onto the anterior abdominal wall in the plane deep to Scarpa fascia.

Clinical Correlate

Laceration of Membranous or Penile Urethra

Accumulation of fluid in the scrotum, around the penis, and in the anterolateral abdominal wall is indicative of a laceration of either the membranous or penile urethra. This can be caused by trauma to the perineal region (saddle injury) or laceration of the urethra during catheterization.

The floor of the pelvis is formed by the pelvic diaphragm. This diaphragm is formed by two layers of fascia with a middle layer of skeletal muscle. The muscles forming the middle layer are the levator ani and coccygeus muscles. The levator ani acts as a muscular sling for the rectum and marks the boundary between the rectum and anal canal.

The region below the pelvic diaphragm is the perineum. The perineum contains the ischioanal fossa, which is the fat-filled region below the pelvic diaphragm, which surrounds the anaj canal. The urogenital diaphragm is in the perineum and extends between the two ischiopubic rami. The urogenital diaphragm (like the pelvic diaphragm) is composed of two layers of fascia with a middle layer of skeletal muscle.

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