Fig. 12. A. Connective tissue planes and spaces of the female pelvis. Frontal section through female pelvis near upper third of vagina. The paravesical (PVS) is shown lateral to the bladder (Blad.). The vesicovaginal space (VVS) is seen between the bladder and vagina, and the rectovaginal space (RVS) is shown between the vagina and the rectum. The paired pararectal spaces (PRS) are seen lateral to the rectum. Note that the ischial spines (IS) are found in the lateral wall of the pararectal spaces. The cardinal ligaments of the vagina (horizontal connective tissue ground bundle) are shown extending from the sides of the vagina to the pelvic wall. The tissue fuses laterally to the connective tissue capsule of the levator ani (LA), which itself takes origin from the fascia of the obturator internus muscle along a white line identified as the arcus tendineous (AT). The rectovaginal septum (RVSe) is noted between the vagina and the rectovaginal space. The ureters (U) can be seen in the tissue between the paravesical space and the vesicovaginal space. Note the retrorectal space (RRS). B. Diagrammatic cross section of the female pelvis through the cervix. The prevesical space (PrVS) is seen anterior to the bladder. It is separated from the paravesical space (PaVS) by the ascending bladder septum (ABSe). The latter also separates the paravesical space from the vesicocervical space (VCS). The descending rectal septum (DRS) separates the retrorectal space (RRS) from the pararectal space (PaRS). Note the posterior cul-de-sac (CD) and cardinal ligament (CL). (Adapted from von Peham H, Amreich J: Operative Gynecology. LK Ferguson (trans): Philadelphia, JB Lippincott, 1934)