PERINEOLOGY. ANATOMY OF PERINEUM. MUSCLES AND FASCIAE (LECTURE)

Abstract

Perineology is a complex scientific branch studying the development, structure and functions of the perineum in normal and various pathological conditions, native and acquired. Considering the gender and constitutional features of the perineum, frequent anatomical and functional disorders of the perineum in pelvic floor and pelvic organs diseases, intensive surgical activity in this area, it was found to be significant to organize available perineum anatomy knowledge according to clinical requests. Present lecture deals with the anatomy of perineum anal and urogenital regions given the structure of their mascular fascial structures and anatomical and functional connections with the pelvic organs, and describes the structure of the postanal plate in detail. Data have been obtained by literature review and specially dissected cadaverous material study. Detailed description of individual anatomy of the muscles and fasciae of the perineum is presented. In the part devoted to anal area particular attention is given to m. levator ani and sphincter ani externus, which are the main functional units in the rectal closing system. The priority in the description of the urogenital region is given to the gender features of the muscles. Perineal fasciae are described considering their origin, which is necessary for the formation of knowledge about the topography of the perineum, fat filled and interfacial spaces; particular attention is paid to the presentation of the pelvic fascia anatomy, both parietal and visceral layer. In conclusion, a holistic view of the anal and urogenital regions of the perineum is given, with their layered structure description. The novelty of the lecture is the usage of updated perineological terms along with traditional and outdated, though widely used in clinical literature; also the explanation of their replacement is given.