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Lack of striated muscle fibers in the longitudinal anal muscle of elderly Japanese: a histological study using cadaveric specimens

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Abstract

Purpose and methods

The aim of this study is to investigate variations in the longitudinal anal muscle (LAM), especially in the meeting pattern between the levator ani and rectum at the origin of the LAM. We examined the histology of the anal canal and the lower rectum of 50 cadavers (25 males, 25 females) of elderly Japanese individuals with the aid of immunohistochemistry.

Results

We observed two patterns in the meeting site between the levator ani and the rectum. In type 1, observed in 26 specimens, the smooth muscle-rich fascia lining the internal or medial aspect of the levator ani (i.e., the fascia pelvis parietalis or endopelvic fascia) was connected to the external muscle layer. In type 2, observed in 24 specimens, multiple intramuscular septa of the levator ani were attached to a smooth muscle mass, with the latter joining the external smooth muscle layer of the rectum. However, 21 specimens (6 type 1 and 15 type 2) carried few smooth muscles at the meeting site. We did not find any striated muscle in the LAM, although this might have been the result of age-associated degeneration. Thus, active traction of the pelvic viscera by the LAM seemed unlikely in elderly Japanese.

Conclusions

Rather than playing an active role, as suggested by the integral pelvic floor theory, the LAM seemed to be an elastic skeleton that maintains the shape of the anal canal.

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Acknowledgments

We thank the people who donated their bodies after death to Tokyo Dental College for research and education on human anatomy without any socioeconomic benefit. We also thank their families for agreeing to these donations and for their patience in awaiting the return of bones after the end of this study. This study was supported by a grant (0620220–1) from the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Anatomy, Chonbuk National University Medical School, Jeonju, Korea

    Ji Hyun Kim

  2. Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, Sizuoka, Japan

    Yusuke Kinugasa

  3. Department of Surgery and Biomedical Research Institute, Chonbuk National University Medical School, Jeonju, Korea

    Hee Chul Yu & Baik Hwan Cho

  4. Division of Internal Medicine, Iwamizawa Asuka Hospital, Hokkaido, Japan

    Gen Murakami

  5. Department of Anatomy, Tokyo Dental College, Tokyo, Japan

    Shinichi Abe

  6. Department of Surgery, Chonbuk National University Hospital, Jeonju, Korea

    Hee Chul Yu

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  1. Ji Hyun Kim
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  2. Yusuke Kinugasa
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  3. Hee Chul Yu
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  4. Gen Murakami
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  5. Shinichi Abe
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Correspondence to Hee Chul Yu.

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Kim, J.H., Kinugasa, Y., Yu, H.C. et al. Lack of striated muscle fibers in the longitudinal anal muscle of elderly Japanese: a histological study using cadaveric specimens. Int J Colorectal Dis 30, 43–49 (2015). https://doi.org/10.1007/s00384-014-2038-0

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  • DOI: https://doi.org/10.1007/s00384-014-2038-0

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