No confusion on the nomenclature of female urethra
No confusion on the nomenclature of female urethra:
(For Uroacademy: Pankaj Joshi, Sanjay B Kulkarni. Kulkarni Reconstructive Urology Center,Pune, India.
In a four legged animal like a dog the face is the anterior surface and tail is posterior. The back surface instead of superior is conventionally called dorsal surface, so the abdomen becomes ventral surface.
The anatomical position of a human being is defined in standing position. The back is posterior or dorsal surface and front becomes anterior or ventral surface.
The position of penis is considered in a functionally erect posture.
The male urethra is divided into anterior portion of penile and bulbar, the posterior portion of membranous and prostatic urethra. The anterior urethra facing the corpora is called dorsal and not posterior to avoid confusion with membranous and prostatic urethra. The urethra facing the surgeon operating in the perineum is called ventral surface.
Posterior urethra makes a U turn so the dorsal wall of bulbar urethra becomes the anterior wall of membranous urethra and prostate. Similarly ventral wall of bulbar urethra continues as the posterior wall of membranous and prostatic urethra.
Female urethra is akin to male membranous urethra and it is sphincter active in its whole length. The female urethra has pubic surface called ventral or anterior and vaginal side called posterior or dorsal surface.
When it comes to female urethra, most of the oldliterature has quoted pubic side as dorsal and vaginal side as ventral.
This is anatomically wrong nomenclature and has led to confusion amongst the urologists and gynecologists.
Let us explain why this is wrong:
Consider the true nomenclature as per the anatomical standing position.
The nomenclature does not change even if the patient’s position is changed.
In a female patient undergoing a trans pubicurethroplasty for pelvic fracture urethral injury, the anterior bladder wall continues as anterior/ ventral/ pubic side of a female urethra. Otherwise, the literature has labelled the anterior wall as dorsal wall which is wrong.
Consider female in a lithotomy position for cystocele repair. Cystocele is on the posterior wall of the bladder,it continues as the posterior/ dorsal or vaginal side of the urethra.
Otherwise, the literature has labelled the posterior wallas ventral wall which is wrong.
The truth about nomenclature in female urethra is
Pubic side or anterior wall of urethra is the ventral wall
And vaginal side or posterior wall of urethra is the dorsal wall.
The truth is eternal.