Abstract

The male pelvic floor is a complex structure formed by several muscles. The levator ani muscle and the perineal muscles are important components of the pelvic floor. The perineal muscles comprise the external anal sphincter, bulbospongiosus, superficial transverse perineal muscles, and ischiocavernosus. Although the connections of the muscles of the pelvic floor have been reported recently, the anatomical details of each muscle remain unclear. In this study, we examined the male pelvic floor to clarify the connection between the muscles related to function. Fifteen male pelvises were used for microscopic dissection, and three male pelvises were used for histological examination. On the lateral aspect, the perineal muscles were connected to each other. Bundles of the levator ani muscle extended to connect to the perineal muscles. In addition, the extended muscle bundle from the levator ani muscle and the perineal muscles surround the external urethral sphincter. On the medial aspect, the levator ani muscle and the external anal sphincter form the anterior and posterior muscular slings of the anal canal. The connection between the perineal muscles and levator ani muscle indicates a possible close relationship between the functions of the urethra and anus.

Highlights

  • The perineum is the caudal layer of the pelvic floor, which is involved in various types of perineal surgeries, such as a perineal prostatectomy

  • The perineum consists of several muscles, known as the perineal muscles, which play a role in controlling the opening of the rectum and urogenital passages (Schuenke et al 2006; Standring 2016; FCAT 1998)

  • The muscle bundles of the bulbospongio‐ sus covering the outer surface of the penile bulb and the cor‐ pus spongiosum were connected to the contralateral muscle bundle at the median line (Fig. 1)

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Summary

Introduction

The perineum is the caudal layer of the pelvic floor, which is involved in various types of perineal surgeries, such as a perineal prostatectomy. This region is recognized as a complex region in males compared to females (Muro et al 2018; Nakajima et al 2017; Oh and Kark 1973). The levator ani muscle is in the deep muscle layer of the perineal muscles, which are essential in supporting the abdominal and pelvic organs. This was confirmed by magnetic resonance imaging and histological studies (Wei and Delancey 2004)

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