Recommended standardized anatomic terminology of the posterior female pelvis and vulva based on a structured medical literature review.

ABSTRACT BACKGROUND Anatomic terminology in both written and verbal forms has been shown to be inaccurate and imprecise. OBJECTIVES We aimed to (1) review published anatomic terminology as it relates to the posterior female pelvis, posterior vagina, and vulva; (2) compare these terms to Terminologia Anatomica, the internationally standardized terminology, and (3) compile standardized anatomic terms for improved communication and understanding. STUDY DESIGN MEDLINE was searched from inception until April 6, 2018 using 40 search terms relevant to posterior female pelvic and vulvar anatomy. Eleven investigators reviewed identified abstracts and selected those reporting on posterior female pelvic and vulvar anatomy for full-text review. Eleven textbook chapters were also included. Definitions of all pertinent anatomic terms were extracted for review. RESULTS In all, 486 anatomic terms were identified describing the vulva and posterior female pelvic anatomy, including the posterior vagina. Terminologia Anatomica has previously accepted 186 of these terms. Based on this literature review, we propose the adoption of 11 new standardized anatomic terms including: 6 regional terms (anal sphincter complex, anorectum, genital-crural fold, interlabial sulcus, posterior vaginal compartment, and sacrospinous-coccygeus complex), 4 structural terms (greater vestibular duct, anal cushions, nerve to the levator ani, and labial fat pad), and 1 anatomic space (deep postanal space). In addition, the current accepted term rectovaginal fascia/septum was identified as controversial and requires further research and definition prior to continued acceptance or rejection in medical communication. CONCLUSION This study highlights variability in the anatomic nomenclature used in describing the posterior female pelvis and vulva. We recommend the use of standardized terminology to improve communication and education across medical and anatomic disciplines.