PERINEUM

dr. Edi Patmini SS, SpOG/dr. M. Nurhadi Rahman, SpOG

 PERINEUM
• Lies inferior to the pelvic outlet
and is separated from the pelvic
cavity by the pelvic diaphragm
(Levator ani and coccygeus
muscles)
• Bounded by
• Pubic symphysis anteriorly;
• inferior pubic rami and ischial
rami anterolaterally;
• ischial tuberosity laterally;
• sacrotuberous ligament
posterolaterally;
• sacrum and coccyx inferiorly
 TWO TRIANGLES
• An imaginary transverse line
joining the anterior ends of the
ischial tuberosities divides the
perineum into two triangles
• Anal triangle (posterior) contains
the anus
• Urogenital triangle (anterior)
contains the root of the scrotum
and penis in males or the external
genitalia in females
• The perineal membrane stretches
between the two sides of the
pubic arch and covers the
anterior part of the outlet
PERINEUM MUSCLES
 Urogenital region

• Placed between two ischiopubic

rami
• In females contains urethral and
vaginal orifice & female external
genitalia
• Three membranes
• Two spaces
 ANAL REGION
• Triangular area between the posterior margin of the urogenital diaphragm
& the coccyx
• Transmits the anal canal
 ANAL CANAL
• Anal canal is surrounded by external
anal sphincter
• Anal canal is connected to the coccyx
by anococcygeal ligament
• On either side of canal is a triangular
space called ischiorectal fossa
• Perineal body (central tendon of
perineum) is situated 1.25 cm anterior to
anal canal
 THE PERINEAL BODY
Structurally perineal body is an irregular fibro muscular mass, containing both
collagenous and elastic fibers and both skeletal and smooth muscles. It is the
site of convergence of several muscles:
1. Bulbospongiosus,
2. Superficial transverse perinea
3. Superficial part of external anal sphincter
4. Sphincter urethrae
5. Deep transverse perinea,
6. Deep part of external anal sphincter and
7. Levator ani
 PERINEAL FASCIA
• There are two fascia in perineum.
• The superficial fascia from anterior abdominal wall extends into the perineum
and get attached to the bony landmarks and free border of perineal
membrane.
• The levator ani muscle is present at the pelvic outlet and forms pelvic
diaphragm.
• The levator ani muscle is covered by fascia, superior fascia of perineum. This
fascia closes to the free border of perineal membrane. Between perineal
membrane and superior fascia of perineum, the space is called as deep
perineal space/pouch.
• Between perineal membrane and fascia descending from anterior
abdominal wall, is the superficial perineal space/pouch.
PERINEAL FASCIA
JAZAKUMULLAH
KHAIRAN KATSIRO
May Allah rewars you with many goodness