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A Novel Concept for the Surgical Anatomy of the Perineal Body

  • Original Contributions
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Diseases of the Colon & Rectum

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.

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Acknowledgment

The authors thank Margot Yehia for assistance.

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Authors and Affiliations

  1. Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt

    Ahmed Shafik M.D., Ph.D., Ali A. Shafik M.D., M.Ch. & Ismail A. Shafik M.D., M.Ch.

  2. Department of Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt

    Olfat El Sibai M.D., Ph.D.

Authors
  1. Ahmed Shafik M.D., Ph.D.
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  2. Olfat El Sibai M.D., Ph.D.
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  3. Ali A. Shafik M.D., M.Ch.
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  4. Ismail A. Shafik M.D., M.Ch.
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Corresponding author

Correspondence to Ahmed Shafik M.D., Ph.D..

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Shafik, A., Sibai, O.E., Shafik, A.A. et al. A Novel Concept for the Surgical Anatomy of the Perineal Body. Dis Colon Rectum 50, 2120–2125 (2007). https://doi.org/10.1007/s10350-007-9064-8

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  • DOI: https://doi.org/10.1007/s10350-007-9064-8

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