The female reproductive organs are interposed between the rectum and bladder. The rectovaginal space is the most dependent location in the female pelvis and is accessible through the vaginal cul-de-sac/vault.
The pelvic floor is made up of the levator sling. The perineal diaphragm lies anteriorly, caudal to the puborectalis portion of the levators. These muscles are divided in an abdominoperineal resection of the rectum. The convergence of the posterior border of the perineal diaphragm and the medial fibers of the puborectalis at the anterior border of the anal sphincter complex is called the central point of the perineum. The middle rectal artery reaches the lateral wall of the rectum running on the cephalad surface of the levators from its origin off internal iliac. The uterine artery crosses over the pelvic portion of the ureter (“water under the bridge”) in its course to the lateral border of the uterus.