# Anatomy and license provenance

The core anatomical surfaces are atlas meshes, not parametric capsules or tubes. Thin luminal layers, the constructed disease and missing small structures are sculpted to that coordinate frame. One model unit is one centimetre. X is anatomical left, Y superior, Z anterior. The register origin in the original metre frame is [0, 0.805, 0.015].

| Source | Material used | Attribution and license |
|---|---|---|
| [Open3DAnatomy: pelvic floor and perineum](https://anatomytool.org/content/open3danatomy-3d-model-pelvic-floor-and-perineum-english-labels) | Primary bladder, prostate capsule, urethral reference, erectile tissues, perineal muscles, vessels, nerves and cropped bone | Marco C. DeRuiter, Eungyeol Lee, Daniël Jansma, O. Paul Gobée and colleagues, LUMC. CC BY-SA 4.0. Original GLB is included. |
| [Z-Anatomy](https://github.com/Z-Anatomy/Models-of-human-anatomy) | Seminal glands, terminal vasa and ejaculatory ducts; shared source ancestry of the main model | Gauthier Kervyn and Z-Anatomy contributors. CC BY-SA 4.0. |
| [Anatria-3D](https://github.com/Nurkan1/Anatria-3D) | Segmented export of the Z-Anatomy reproductive model | Source reproductive GLB included; repository NOTICE and LICENSE retained under licenses/. |
| [BodyParts3D / DBCLS](https://dbarchive.biosciencedbc.jp/en/bodyparts3d/) | Source ancestry of the anatomical meshes | Kousaku Okubo and collaborators, Database Center for Life Science. The Z-Anatomy source retains the original CC BY-SA 2.1 Japan credit. Current DBCLS distribution separately lists CC BY 4.0; this app does not use that change to remove inherited attribution or ShareAlike. |
| [Anatomy, unfolded., Brian Pridgen](https://anatomy-unfolded.brianp.chatgpt.site) | User-specified visual and interaction reference | New code implementation. No reference-site model, JavaScript, font asset or stylesheet is distributed. No endorsement implied. |

All adapted atlas geometry and the geometry additions in this distribution are offered under [CC BY-SA 4.0](https://creativecommons.org/licenses/by-sa/4.0/). Attribute the above sources, identify modifications, link the license, and preserve ShareAlike for redistributed adaptations. These model licenses do not grant rights in third-party trademarks or imply clinical validation.

Original model endpoints: [Open3D pelvic floor GLB](https://caskanatomy.info/open3dviewer/3dmodels/pelvicfloor/pelvicfloor.glb), [Z-Anatomy reproductive GLB export](https://raw.githubusercontent.com/Nurkan1/Anatria-3D/main/public/anatomy/reproductive_male.glb). The included atlas.json records each processed mesh's source name, source project, mirroring and binary offsets. The preparation script can reproduce the crop from the two included originals.

## Modifications

The mesh crop removes the abdomen, thighs, scrotal/testicular structures and excess posterior pelvic anatomy. The source right-sided branches and selected muscles are mirrored where a left equivalent is needed; centrally complete muscles are split at the midline. The source spongiosum is divided into bulb and shaft, with the constructed 1.8 cm diseased interval removed from the healthy sponge display. The spongiofibrosis teaching addition is a complete hollow sleeve around the mucosal wall in that interval, with schematic thickness and a patent central opening. It replaces the earlier cropped outer-surface scar. During the disease reveal, this sleeve moves aside while the narrowed urethral wall stays in place. Crura and cavernosa are separately selectable. The bladder cut face is derived from its mesh contour, with an inset cavity. The urethral centerline follows measured atlas landmarks, with an anterior adjustment within the prostate. Mucosal wall, true luminal section, sphincter complex, Cowper glands and ducts, small prostatic/bladder landmarks, bulbar/common penile arteries, dorsal nerves, thin fascia/tunica and treatment overlays are teaching additions. They are not patient-specific segmentations or validated surgical anatomy.

## Clinical and terminology sources

- [AUA Urethral Stricture Disease guideline (2016; amended 2023)](https://www.auanet.org/guidelines-and-quality/guidelines/urethral-stricture-guideline), statement 7: initial short bulbar dilation/DVIU. Statement 11b permits urethral dilation, or DVIU combined with drug-coated balloons, for recurrent bulbar strictures <3 cm (Conditional Recommendation; Evidence Level Grade B).
- [EAU disease management in males](https://uroweb.org/guidelines/urethral-strictures/chapter/disease-management-in-males): selected recurrent bulbar drug-coated balloon eligibility after at least two endoscopic treatments when urethroplasty is declined or unsuitable; transecting versus non-transecting repair; selected transecting EPA anatomical patency and bulbar free-graft patency summaries. These are not directly comparable randomized estimates. Section 6.3.2.e.3 supports choosing dorsal or ventral graft position by expertise and operative findings; the shared free-graft range is not a position-specific estimate.
- [DoVeBuG trial registration, NCT02551783](https://clinicaltrials.gov/study/NCT02551783): anatomical descriptions of dorsal tunica albuginea and ventral corpus spongiosum graft beds. Used for anatomy only; this terminated trial does not supply the outcome estimate.
- [EAU diagnostic evaluation](https://uroweb.org/guidelines/urethral-strictures/chapter/diagnostic-evaluation): history, flow/residual urine, RUG with VCUG where appropriate, and endoscopy.
- [FDA Optilume labeling](https://www.accessdata.fda.gov/cdrh_docs/pdf21/P210020C.pdf), section 11.2: treatment length extends beyond scar edges. The thin overlay is conceptual, not an instruction for choosing a device.
- [FIPAT Terminologia Anatomica, second edition, Part III](https://cdn.dal.ca/content/dam/dalhousie/pdf/library/FIPAT/TA2/FIPAT-TA2-Part-3.pdf), entries 3443-3462: urethral subdivisions, sphincters, crest, colliculus, utricle, fossa, meatus and mucosa. Individual TA2 terms are public domain; the full PDF is CC BY-ND 4.0. Clinical labels such as bulbar portion, common penile trunk, spongiofibrosis and prostatic extension are distinguished from canonical terms.

Outcome percentages are withheld from the teaching cards pending complete endpoint and source mapping. Selected-series ranges are not your prognosis and are not a comparison of techniques. Endpoints, follow-up, case mix and technique differ. This case has no trauma-associated posterior distraction defect, sphincter involvement or meatal scar. Treatment history in the balloon overlay is a hypothetical recurrence scenario applied to the same specimen.

## Teaching scope and language

- [LSE staging paper (2024 online; 2025 print)](https://doi.org/10.1097/JU.0000000000004369). Stage I is approximate for this constructed 1.8 cm bulbar lesion. No precise E code is assigned before idiopathic and inflammatory etiologies are split. Lichen sclerosus is a distinct etiology.
- The 12 o'clock cold-knife direction is a teaching convention, not a universal operative instruction.
- AUA statement 11b does not impose the EAU requirement for at least two prior endoscopic treatments or urethroplasty to be declined or unsuitable. The balloon history is hypothetical.
- Translations are machine-generated. English is the clinical reference. New teaching explanations are currently in English. Spanish terminology remains flagged for human clinical review.
- Cropped and smoothed meshes, instruments and suture counts are schematic. This is not a patient, a RUG or an operative simulator.