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. 2022 Mar;33(3):453-457.
doi: 10.1007/s00192-022-05087-8. Epub 2022 Feb 3.

Lies, damned lies, and pelvic floor illustration: Confused about pelvic floor anatomy? You are not alone

John O L DeLancey  1
Affiliations

Lies, damned lies, and pelvic floor illustration: Confused about pelvic floor anatomy? You are not alone

John O L DeLancey. Int Urogynecol J. 2022 Mar.

Abstract

Dissection reveals elegant simplicity in pelvic floor structure. So, why are so many of us confused about the pelvic floor? The pelvic floor is in an invisible region between what we see from above and below, so our experience does not help. It is confusing because there is conflict between existing illustrations, so we do not know which are false and which are true. To resolve conflicts in pelvic anatomy we must: recognize the Vesalian principle that truth lies in the body, not necessarily in books; commit to focusing on structures rather than words; and overcome "theory-induced blindness," the psychological principle that discounts what is seen when it contradicts a theory we believe. We should revive century-old standards that require accuracy in anatomical illustration analogous to the p value in statistics. Committing to anatomical accuracy will ensure that we no longer navigate in surgery and research using a flawed map.

Keywords: Anatomy; Endopelvic fascia; Levator ani; Pelvic floor; Perineal membrane; Truth.

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