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3D Visualization of the Male Pelvis and Perineum:
An Argument for Revision of Classic Representations of the Region

Judith M. Venuti, Ph.D., 1,2 Celina Imielinska, Ph.D.,1,3 Lisa Laino-Pepper, M.S.,4 Richard Thumann, M.S.,5 and Pat Molholt , Ph.D.1

1Office of Scholarly Resources, College of Physicians and Surgeons of Columbia University
2Department of Anatomy and Cell Biology, College of Physicians and Surgeons of Columbia University
3Department of Computer Science, Columbia University
4Department of Computer Science, Rutgers University
5Department of Computer Science, Stevens Institute of Technology


Abstract

     A clear understanding of the pelvic anatomy is crucial for male and female pelvic surgery as well as the fundamental mechanisms of urogenital dysfunction and its treatment. This region is conceptually difficult and is best understood when important 3D relationships are adequately represented. Conventional 2D illustrations of the pelvic region in texts and atlases are often insufficient and students of anatomy would benefit from 3D computer generated models of this region. We therefore generated 3D models of the male pelvic anatomy from the male Visible Human dataset. The models generated from these segmentations are surface-based and textured in photographic quality, fresh human tissue color, providing a uniquely realistic representation of the anatomy. Our 3D reconstructions reveal inconsistencies between the VH images and classic anatomical illustrations of this region. For example, the levator ani muscle which forms the majority of the pelvic diaphragm is classically depicted as a hammock-like structure which supports the pelvic viscera and hence the term "diaphragm". The 3D images of this structure show instead that the levator ani is considerably more cylindrical and has vertical walls that are in close apposition to the prostate. Similarly, the urinary bladder is conventionally represented as a balloon-like structure that sits directly above and on the prostate. Our images reveal that the bladder is positioned anterior to the prostate, so that the angle between the bladder neck and the prostate is more oblique than vertical. Lastly, our detailed analysis of the muscles of the perineum, particularly the muscles of the urogenital diaphragm, show their relationship to the pelvic viscera is different from the classic view.

 
Keywords: 3D visualizations, external genitalia, levator ani, pelvic diaphragm, pelvis, perineum, prostate, urinary bladder, Visible Human

 
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