MODERN CONCEPTS OF FASCIAL STRUCTURES OF THE PERINEAL AREA: ANATOMICAL AND TOPOGRAPHIC FEATURES

The article reviews the modern scientific literature on the fascial structures of the perineal area. Particular attention is paid to the anatomical, morphological and functional features of the fascia, which play a key role in supporting the pelvic organs, transferring the load and possible ways of spreading pathological processes. The fascial structures of the perineum have a complex multilayered structure and form interconnected anatomical spaces. The article highlights the issues of terminology and classification of the perineal fascia in accordance with the modern international anatomical nomenclature. Their morphofunctional characteristics, connections with surrounding structures, in particular with the muscles of the pelvic floor, urogenital diaphragm and elements of the neurovascular bundle, are considered. The significance of fascial formations in the context of clinical anatomy is separately analyzed, in particular their role in the development of inflammatory processes, the spread of infections and the formation of hernial protrusions. Attention is focused on the participation of fascia in pathological conditions, such as perineal abscesses, urethral and rectal fistulas, as well as surgical approaches to the correction of these conditions. Thus, a detailed study of the fascial structures of the perineal area is important for understanding the topographic and anatomical features of this zone, which will contribute to improving the diagnosis and treatment of diseases of the pelvic region. Purpose of the study. Analysis and generalization of modern scientific sources. The purpose of the study is to analyze and generalize modern scientific sources on the morphological and functional features of the fascial structures of the perineal area. The study is aimed at clarifying their anatomical structure, variant anatomy, relationships with adjacent structures, as well as their role in supporting the pelvic floor organs and the spread of pathological processes. Material and methods. To conduct a literature review, an analysis of modern scientific sources was carried out that highlight the anatomical structure, morphofunctional features and clinical significance of the fascial structures of the perineum. Sources were selected based on their relevance, methodological validity and compliance with modern anatomical nomenclature. The literature search was carried out in the PubMed, Google Scholar databases and specialized monographs using the keywords: fascia perinei, pelvic fascia, perineal membrane, urogenital diaphragm, Colles’ fascia, Gallaudet’s fascia, Buck’s fascia, perineal anatomy. The main research methods were: systematic literature analysis, comparative anatomical approach (to identify differences in terminology and interpretation of fascial structures). Conclusions. The fascial structures of the perineum are a complex and interconnected system that provides support for the pelvic floor organs, participates in continence mechanisms, and is an important anatomical reference point in surgical practice. The analysis of the literature has shown certain discrepancies in the terminology of the fascial structures of the perineum in different sources. The modern international anatomical nomenclature requires clarification and resolution of contradictions regarding such formations as the perineal membrane, Colles’ fascia, Gallaudet’s fascia, Buck’s fascia, and others. Understanding the anatomy of the fascial structures of the perineum is of key importance for pelvic floor surgery, urology, proctology, and reconstructive medicine. It is especially important to study these structures during surgical interventions in patients with perineal injuries, urinary incontinence, anorectal malformations and other pathologies. The identified gaps in the description of the morphological and functional features of the perineal fascia indicate the need for further research, in particular using modern methods of visualization and morphological analysis. This will contribute to the improvement of diagnostics, surgical interventions and postoperative management of patients.