The presacral component of the visceral pelvic fascia and its relation to the pelvic splanchnic innervation of the bladder

摘要

AbstractThe relation of the autonomic nerve supply of the pelvis to the visceral pelvic fascia and in particular that of the parasympathetic supply to the bladder musculature is of particular consequence in pelvic operations. It is observed that the pelvic splanchnics, including those branches supplying the bladder, are embedded in the peripheral component of the visceral pelvic fascia or presacral fascia throughout a considerable part of their course. Early anatomists made no distinction between the presacral fascia and the fascial sheath of the rectum proper. Consequently their illustrations shown only a single fascial layer which they call the “rectal fascia” or “posterior fibrous sheath of the rectum” separating the middle sacral vessels from the superior rectal vessels which lie in the pararectal fat. While such a distinction has since been made in the surgical literature, most anatomical descriptions are still rather vague in this respect. It is essential to develop the plane of cleavage between the presacral fascia and the fascial sheath of the rectum if injury to the pelvic splanchnic nerves is to be