Handa 9781496386441 Full Sample Chap 1

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SECTION I  Preparing for Surgery

Body of clitoris

Crus of clitoris

Ischiocavernosus m.

Pubic ramus

I

Bulbospongiosus m.

Urethral orifice

Vestibule of vagina

Perineal membrane

Vestibular bulb

Fossa navicularis

Bartholin gland

Perineal body

Sup. transverse perineal m.

Levator ani m.

FIGURE 1.13  Anterior and posterior perineal triangles. Structures within the superficial compartment of the anterior triangle and their relationship to perineal membrane are shown.

External anal sphincter m.

Anus

Unlike the skin of the labia majora, the cutaneous structures of the labia minora and vestibule do not lie on an adipose layer but on a connective tissue stratum that is loosely organized and permits mobility of the skin during intercourse. This loose attachment of the skin to underlying tissues allows the skin to be easily dissected off the underlying tissue during skinning vul-

vectomy in the area of the labia minora and vestibule. The labia minora are highly sensitive structures that lie in close proximity to the clitoris and vestibular bulbs. Clinically, great variation exists in shape and size of the labia minora. In some women, one or both labia may markedly extend beyond the labia majora and can be drawn into the vagina during coitus or other activities. If

Labia minora

Posterior labial artery and nerves

Bulbospongiosus m.

Ischiocavernosus m.

Perineal body

Transverse perineal m.

Perineal artery and nerves

Pudendal artery and nerves

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Inferior anal (rectal) arteries and nerves

Levator ani m.

External anal sphincter m.

Gluteus maximus m.

FIGURE 1.14  Pudendal nerve and vessels.

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