Skip to main content

Advertisement

Log in

Prevalence and pubo-umbilical index of pyramidalis muscle in a select Kenyan population

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

Pyramidalis is a lower anterior abdominal wall muscle that is considered vestigial and shows variations in prevalence and size. It’s been utilized as an anatomical landmark and harvested for use in various surgical procedures. Despite knowledge of its clinical importance, data on the prevalence of pyramidalis remain absent from the Kenyan population with few studies globally reporting on its pubo-umbilical index. We therefore aimed to determine the prevalence and relative lengths (pubo-umbilical index) of pyramidalis muscle in a sample Kenyan population.

Materials and methods

Fifty-two cadavers (41 males, 11 females) from the Department of Human Anatomy, University of Nairobi were used. Prevalence and length of the muscle (l) were established, and the distance between pubic symphysis and umbilicus (L) measured and used to calculate pubo-umbilical index (l/L ×100%). Independent and paired T tests were done, using SPSS® version 22. A p value of ≤ 0.05 was considered statistically significant at a 95% confidence interval.

Results

Pyramidalis was present in 84% (44) of cadavers; 83% (43) bilaterally, 2% (1) unilaterally, and 85.4% (35) in males, 81.8% (9) in females. Mean length in males and females was 71.8 ± 35 mm and 63.5 ± 37.5 mm, respectively. Mean pubo-umbilical index was 38% ± 18 (39 % ± 18 males, 35% ± 19 females). No statistically significant difference was found.

Conclusion

Pyramidalis is a highly prevalent muscle in the Kenyan population and, hence, could be exploited for its clinical and surgical utilities. The muscle terminates largely within the 2nd quarter (25–50%) of the infra-umbilical linea alba measured from pubic symphysis. Its pubo-umbilical index would be useful to surgeons making midline infra-umbilical incisions and performing procedures involving the muscle.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

References

  1. Ashley-Montagu MF (1939) Anthropological significance of the musculus pyramidalis and its variability in man. Am J Phys Anthopol 15:435–490

    Article  Google Scholar 

  2. Cirocchi R, Cheruiyot I, Henry BM, Artico M, Gioia S, Palumbo P, Kipkorir V, D’Andrea V, Randolph J (2020) Anatomical variations of the pyramidalis muscle: a systematic review and meta-analysis. Surg Radiol Anat 24:1–11

    Google Scholar 

  3. Coffield JA, Bakry N, Carlson J, Gomella LG, Simpson LL (1997) In vitro characterization of botulinum toxin types A, C and D action on human tissues: combined electrophysiologic, pharmacologic and molecular biologic approaches. J Pharmacol Exp Ther 280(3):1489–1498

    CAS  PubMed  Google Scholar 

  4. Das SS, Saluja S, Vasudeva N (2017) Biometrics of pyramidalis muscle and its clinical importance. J Clin Diagn Res 11(2):AC05–AC07

    PubMed  PubMed Central  Google Scholar 

  5. Dickson MJ (1999) The pyramidalis muscle. J Obstet Gynaecol 19(3):300

    Article  CAS  Google Scholar 

  6. Didia B, Loveday O, Christian I (2009) Variation and incidence of agenesis of the pyramidalis muscles in Nigerian males. J Exp Clin Anat 8(1):8

  7. Gilleard WL, Brown JMM (1996) Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period. J Phys Ther 76(7):750–762

    Article  CAS  Google Scholar 

  8. Gool V, Jong D (1999) Urinary continence and erectile function after bladder neck sling suspension in male patients with spinal dysraphism. BJU Int 83(9):971–975

    PubMed  Google Scholar 

  9. Jit I, Banga N (1986) Incidence of pyramidalis muscle in north Indian subjects. J Anat Soc India 35(1):21–27

    Google Scholar 

  10. Kaur H, Singla RK, Brar RS, Singla M (2016) Study of the morphometry of the pyramidalis muscle and its incidence in the Indian population. Int J Anat Res 4(2):2207–2211

    Article  Google Scholar 

  11. Lee SC, Endo Y, Potter HG (2017) Imaging of groin pain: magnetic resonance and ultrasound imaging features. Sports health 9(5):428–435

    Article  Google Scholar 

  12. Lovering RM, Anderson LD (2008) Architecture and fiber type of the pyramidalis muscle. Anat Sci Int 83(4):294–297

    Article  Google Scholar 

  13. Mingin GC, Youngren K, Stock JA, Hanna MK (2002) The rectus myofascial wrap in the management of urethral sphincter incompetence. BJU Int 90(6):550–553

    Article  CAS  Google Scholar 

  14. Mori M (1964) Statistics on the musculature of the Japanese. Okajimas Folia Anat Jpn 40(3):195–300

    Article  CAS  Google Scholar 

  15. Natsis K, Piagkou M, Repousi E, Apostolidis S, Kotsiomitis E, Apostolou K, Skandalakis P (2016) Morphometric variability of pyramidalis muscle and its clinical significance. Surg Radiol Anat 38(3):285–292

    Article  Google Scholar 

  16. Schilders E, Bharam S, Golan E, Dimitrakopoulou A, Mitchell A, Spaepen M, Beggs C, Cooke C, Holmich P (2017) The pyramidalis–anterior pubic ligament–adductor longus complex (PLAC) and its role with adductor injuries: a new anatomical concept. Knee Surg Sports Traumatol Arthrosc 25(12):3969–3977

    Article  Google Scholar 

  17. Standring S (2020) Gray’s anatomy E-Book: the anatomical basis of clinical practice. Elsevier Health Sciences

    Google Scholar 

  18. Sumino Y, Hirata Y, Hanada M, Akita Y, Sato F, Mimata H (2011) Long-term cryopreservation of pyramidalis muscle specimens as a source of striated muscle stem cells for treatment of post-prostatectomy stress urinary incontinence. Prostate 71(11):1225–1230

    Article  Google Scholar 

  19. Van Landuyt KO, Hamdi MO, Blondeel P, Monstrey S (2003) The pyramidalis muscle free flap. Br J Plast Surg 56(6):585–592

    Article  Google Scholar 

Download references

Funding

No funding.

Author information

Authors and Affiliations

Authors

Contributions

VK: project protocol development, data collection and analysis, AND manuscript writing. BO: project protocol development and manuscript editing. KO: project protocol development and manuscript editing. BN: project protocol development and manuscript editing. IC: data analysis and manuscript editing. Musa Misiani: data management and manuscript editing. JM: data management and manuscript editing.

Corresponding author

Correspondence to Vincent Kipkorir.

Ethics declarations

Conflicts of interest/competing interests

No conflict of interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kipkorir, V., Olabu, B., Ongeti, K. et al. Prevalence and pubo-umbilical index of pyramidalis muscle in a select Kenyan population. Surg Radiol Anat 43, 1461–1466 (2021). https://doi.org/10.1007/s00276-021-02733-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-021-02733-6

Keywords

Navigation