Anatomy · functional reading
Endopelvic fascia
The endopelvic fascia is the connective tissue of the deep pelvis, located between the peritoneum and the pelvic floor muscles. It lines the walls of the pelvis and surrounds the pelvic organs, which it helps to support.
Scientific basis
Two layers are distinguished: a parietal layer, which covers the walls and muscles of the pelvis, and a visceral layer, which surrounds the bladder, the uterus and vagina in women, the prostate in men, and the rectum. It has condensations (so-called “visceral” ligaments, septa, and sheaths that accompany the vessels and nerves) and connects to the perineal membrane (DeLancey 1992; Stein and DeLancey 2008).
Together with the pelvic floor muscles, it contributes to the support and suspension of the pelvic organs: the muscles provide active support, the connective tissues passive support and suspension.
Endopelvic fascia, pelvic fascia and pelvic fasciae: what do these terms refer to? These expressions are often used interchangeably. Depending on the author and the discipline (anatomy, gynecology, urology, colorectal surgery), “pelvic fascia” refers either to all of the layers or to only one of them, and the nomenclature of the endopelvic fascia remains heterogeneous (García-Armengol et al. 2008). It is a complex anatomical and functional category rather than a sharply defined structure.
Blue Portance / SBNFA™ reading
In the SBNFA™ reading, the endopelvic fascia completes the functional anatomy of the deep pelvis. It connects the pelvic floor, the pelvic walls, the organs and the structures that accompany the vessels and nerves. It is not regarded as a single sheet that transmits forces uniformly.
Contribution to the analysis of sitting
Seating analysis provides no information on the condition of the endopelvic fascia. It describes the orientation of the pelvis and the distribution of support, which change the loads placed on the deep pelvis in the seated position; any pelvic pain calls for a medical evaluation.
Not to be confused with
Pelvic floor, the musculofascial complex of which the endopelvic fascia is one component; Perineum, the region located below the pelvic floor; Perineal membrane, the fibrous sheet of the perineum to which it connects; Alcock’s canal, a split in the fascia of the obturator internus muscle that contains the pudendal nerve; Thoracolumbar fascia, the fascia of the lumbar region.
Related terms
Pelvic floor · Perineum · Alcock’s canal (pudendal canal) · Obturator internus · Pudendal nerve · Fascia · Nerve compression · Nerve gliding
Sources and scope
- DeLancey (1992): anatomic aspects of vaginal eversion after hysterectomy, levels of support (American Journal of Obstetrics and Gynecology)
- Stein and DeLancey (2008): structure of the perineal membrane in women, gross and microscopic anatomy (Obstetrics and Gynecology)
- García-Armengol et al. (2008): review of anatomical concepts relating to the retrorectal space and the endopelvic fascia (Colorectal Disease)
An established anatomical concept with a heterogeneous nomenclature. The endopelvic fascia is not a single sheet that transmits forces uniformly; the seated position neither “stretches” nor “damages” it, and pelvic pain cannot be attributed to it without a medical evaluation. The idea of a “locked pelvic fascia” does not correspond to any established anatomical or clinical notion.
Further reading
- Learn more — Article: Pudendal Neuralgia: Why Can a Simple Sitting Position Become an Ordeal?
- Go further — Expert guide: What Role Does Fascia Play in the Pelvis and Pelvic Floor?
