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- Title
A histotopographic study of the perineal body in elderly women: the surgical applicability of novel histological findings.
- Authors
Hideo Soga; Ichiro Nagata; Gen Murakami; Toshihiko Yajima; Atsushi Takenaka; Masato Fujisawa; Masayasu Koyama
- Abstract
Abstract  Female perineal structures located around the perineal body were histologically examined using semiserial sections obtained from 15 elderly female cadavers. The smooth muscle content of the perineal body was greater in multiparous women. The connective tissue of the perineal body extended inferolaterally and provided a fibromuscular mass that was 10â30 mm long mediolaterally and 3â15 mm long superoinferiorly. The lateral extension (LEX) of the perineal body occupies a space that is surrounded by the vestibular bulb, internal anal sphincter, and levator ani slings. The LEX did not directly connect to the ischiopubic bony rami but did connect indirectly via the vestibular bulb and ischiocavernosus. Thus, the LEX appears to play a critical role for maintaining the topographical relationship between the vagina and the rectum. The surgical approximation of bilateral LEX instead of levator ani may be of key importance when doing a perineorrhaphy. As pudendal nerve branches run along the inferior margin of the LEX, a mediolateral episiotomy may not be the best option.
- Subjects
MUSCULOSKELETAL system; SMOOTH muscle; SPHINCTERS; NERVOUS system
- Publication
International Urogynecology Journal, 2007, Vol 18, Issue 12, p1423
- ISSN
0937-3462
- Publication type
Article
- DOI
10.1007/s00192-007-0380-2