Abstract

Background The description of Tryavarta Yoni in the Sushruta Samhita presents the female reproductive passage in three Avartas. A nearby passage describes four Peshis along the Apatyapatha, or birth passage. These descriptions are often compared with the vagina and its surrounding muscles, but an exact anatomical equivalence has not been demonstrated. Objective To examine the classical wording and compare the region of the four Peshis with current knowledge of the distal vaginal wall and pelvic floor. Sources and approach A focused narrative review was undertaken using Sushruta Samhita, Sharira Sthana 5/37– 39 and 5/43, together with original human anatomical studies based on histology, dissection, magnetic resonance imaging, and functional assessment. Textual statements were separated from later anatomical interpretations. Findings Verse 5/43 locates the fetal bed in the third Avarta. Verse 5/39 places two of four Peshis internally along the birth passage and two externally near its opening. Modern studies show a lower vaginal region formed by vaginal smooth muscle, paired superficial perineal muscles, the perineal body and membrane, and the medial levator ani. These structures offer a useful regional comparison, but the evidence does not identify four discrete modern muscles corresponding to the four classical Peshis. Conclusion The Prathama Avarta is best discussed as a lower reproductive passage and its supportive tissues. The proposed correlations are topographical and educational. Direct one-to-one identification needs further textual and anatomical work.