5. Anatomy of the pelvis, pelvic organs and reproductive system

Knowledge of the functional anatomy of the pelvic organs with the surrounding tissues is a key element of safe clinical practice. The internal pelvic organs are firmly attached to each other, the encircling bony pelvic girdle and musculofascial pelvic floor by endopelvic fascia structures. This close relationship combining local anchoring and stretching properties of the mesenchymal tissues with the contractility of the pelvic floor is essential for good daily functioning of the male and female pelvic organs. In this chapter, the localisation, composition of the organ tissues and changes during life are discussed in relation to their functions in urinary and faecal continence, vaginal delivery, fertilisation, locomotion and how they prevent the formation of, for example, cystocele, enterocele, rectocele and vaginal prolapse. Attention is also paid to the development of the reproductive organs, which is essential to understand the wide range of variations and congenital malformations and the complex anatomy of the pelvis with its vascularisation and innervation patterns.