ArticleInternational urogynecology journal2024
Functional Anatomy of Urogenital Hiatus Closure: the Perineal Complex Triad Hypothesis.
Article in International urogynecology journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- T‑shaped sling with modified posterior pelvic reconstruction: a technical note with video vignette.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2025Pooled it
- Perineal Membrane Structural Changes: An Unstudied Aspect of Prolapse.International urogynecology journal · 2026Article
- Compartment-Specific Associations Between Perineal Body Length and Pelvic Organ Prolapse in Postpartum Women.International urogynecology journal · 2026Article
- Urogenital Hiatus Closure System: A Framework for Understanding how Muscle, Motor Control, and Fascial Connections Interact in Normal and Failed Closure.International urogynecology journal · 2026Review
- On Lingering Pelvic Floor Musculoskeletal Injuries in the Postpartum Athlete: Are We Adequately Addressing Them?Sports health · 2026Article
- Pelvic floor morphofunctional characteristics in female rugby players beyond the tackle. Pelvic floor muscles in high-impact sports.Scientific reports · 2026Article
- Pelvic floor myoelectric excitation and force output across menstrual-cycle phases.BMC women's health · 2026Observational
- Perineal structural changes on 3-dimensional endovaginal ultrasound 6 months after difficult vaginal birth: the Hourglass-Band pattern and how it relates to levator ani avulsion and hiatus size.American journal of obstetrics and gynecology · 2026Article
- Three-dimensional pelvic floor ultrasound measuring levator ani hiatus area and its association with pelvic organ prolapse: a population based retrospective cross-sectional study in Chinese women.Quantitative imaging in medicine and surgery · 2026Article
- Multiparametric comparative assessment of surgical efficacy in patients with SUI and POP versus normal controls.Scientific reports · 2026Article
- Urogenital Hiatus Closure: Facts, Fallacies, and Why a Unified Theory of Hiatal Failure is Needed.International urogynecology journal · 2025Article
- Presence of smooth muscle continuous with the rectal and vaginal walls in the deep perineal space prompts reconsideration of the deep transverse perineal muscle.Scientific reports · 2025Article
- Hiatus and pelvic floor failure patterns in pelvic organ prolapse: a 3D MRI study of structural interactions using a level III conceptual model.American journal of obstetrics and gynecology · 2025Article
- Two minutes is sufficient to characterize the viscoelastic properties of the human lower birth canal during the first stage of labor.Clinical biomechanics (Bristol, Avon) · 2025Article
- Neuromodulation Improves Stress Urinary Incontinence-Like Deficits in Female Rabbits.IEEE open journal of engineering in medicine and biology · 2025Article
- Exploring the connection between the hip and pelvic floor in women with exercise-induced urinary incontinence: integrating clinical hypotheses with current evidence.Journal of pelvic, obstetric and gynaecological physiotherapy · 2025Article
- Dynamic biomechanical equilibrium in pelvic organ prolapse: from mechanistic insights to precision reconstruction.Frontiers in medicine · 2025Article
- Pelvic compression garments alter running biomechanics, perceived support, and fear of symptoms in postpartum women with pelvic floor dysfunction: preliminary observations from an exploratory, randomised, repeated-measures crossover design.Frontiers in sports and active living · 2025Article
- Opinions of Gynecologists About Indication and Technique of Perineoplasty.Journal of clinical medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
Abstract
introductionUrogenital hiatus enlargement is a critical factor associated with prolapse and operative failure. This study of the perineal complex was performed to understand how interactions among its three structures: the levator ani, perineal membrane, and perineal body-united by the vaginal fascia-work to maintain urogenital hiatus closure.
methodsMagnetic resonance images from 30 healthy nulliparous women with 3D reconstruction of selected subjects were used to establish overall geometry. Connection points and lines of action were based on perineal dissection in 10 female cadavers (aged 22-86 years), cross sections of 4 female cadavers (aged 14-35 years), and histological sections (cadavers aged 16 and 21 years).
resultsThe perineal membrane originates laterally from the ventral two thirds of the ischiopubic rami and attaches medially to the perineal body and vaginal wall. The levator ani attaches to the perineal membrane's cranial surface, vaginal fascia, and the perineal body. The levator line of action in 3D reconstruction is oriented so that the levator pulls the medial perineal membrane cranio-ventrally. In cadavers, simulated levator contraction and relaxation along this vector changes the length of the membrane and the antero-posterior diameter of the urogenital hiatus. Loss of the connection of the left and right perineal membranes through the perineal body results in diastasis of the levator and a widened hiatus, as well as a downward rotation of the perineal membrane.
conclusionInterconnections involving the levator ani muscles, perineal membrane, perineal body, and vaginal fascia form the perineal complex surrounding the urogenital hiatus in an arrangement that maintains hiatal closure.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.