A Novel Concept for the Surgical Anatomy of the Perineal Body |
| |
Authors: | Ahmed Shafik Olfat El Sibai Ali A Shafik Ismail A Shafik |
| |
Institution: | (1) Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt;(2) Department of Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt |
| |
Abstract: | Purpose Perineal body is considered by investigators as a fibromuscular structure that is the site of insertion of perineal muscles.
We investigated the hypothesis that perineal body is the site across which perineal muscles pass uninterrupted from one side
to the other.
Methods Perineal body was studied in 56 cadaveric specimens (46 adults, 10 neonatal deaths) by direct dissection with the help of
magnifying loupe, fine surgical instruments, and bright light.
Results Perineal body consisted of three layers: 1) superficial layer, which consisted of fleshy fibers of the external anal sphincter
extending across perineal body to become the bulbospongiosus muscle; 2) tendinous extension of superficial transverse perineal
muscle crossing perineal body to contralateral superficial transverse perineal muscle, with which it formed a criss-cross
pattern; and 3) tendinous fibers of the deep transverse perineal muscle; the fibers crossing perineal body decussated in criss-cross
pattern with the contralateral deep transverse perineal muscle. A relation of levator ani or puborectalis muscles to perineal
body could not be identified.
Conclusions Perineal body (central perineal tendon) is not the site of insertion of perineal muscles but the site along which muscle fibers
of these muscles and the external anal sphincter pass uninterrupted from one side to the other. Such a free passage from one
muscle to the other seems to denote a “digastric pattern” for the perineal muscles. Perineal body is subjected to injury or
continuous intra-abdominal pressure variations, which may eventually result in perineocele, enterocele, or sigmoidocele. |
| |
Keywords: | Perineal muscles External anal sphincter Bulbospongiosus Perineocele Enterocele Sigmoidocele |
本文献已被 PubMed SpringerLink 等数据库收录! |
|