Observational studyInternational urogynecology journal2024
Skeletal Muscle Complex Between the Vagina and Anal Canal: Implications for Perineal Laceration.
Observational study in International urogynecology journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
6 citing papers in PubMed.
- Perineal Membrane Structural Changes: An Unstudied Aspect of Prolapse.International urogynecology journal · 2026Article
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Urogenital Hiatus Closure System: A Framework for Understanding how Muscle, Motor Control, and Fascial Connections Interact in Normal and Failed Closure.International urogynecology journal · 2026Review
- Two layers of fascia envelop the pudendal nerve canal: a cadaver study.International journal of colorectal disease · 2026Article
- Perineal structural changes on 3-dimensional endovaginal ultrasound 6 months after difficult vaginal birth: the Hourglass-Band pattern and how it relates to levator ani avulsion and hiatus size.American journal of obstetrics and gynecology · 2026Article
- Presence of smooth muscle continuous with the rectal and vaginal walls in the deep perineal space prompts reconsideration of the deep transverse perineal muscle.Scientific reports · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
introduction and hypothesisThe anatomy of the skeletal muscles located between the vagina and anus is important during complex obstetric laceration reconstructions. We aimed to clarify the composition of skeletal muscles located between the vagina and anal canal and their three-dimensional configuration relevant to perineum repair.
methodsThis observational study involved ten female cadavers. An anatomical dissection was performed to observe the muscles around the vagina and anal canal. Immunohistological analysis of the midsagittal section was performed to clarify the composition of the muscles, and dissection was performed to correspond to the cross-section. Wide-range serial sectioning and three-dimensional reconstruction were used to support these findings histologically and visualize the three-dimensional arrangement.
resultsThe region between the vagina and anal canal included the anterior part of the external anal sphincter, superficial transverse perineal muscle approaching from the lateral side, and levator ani, located cranially. They converge three-dimensionally in the median from each direction, forming a muscle complex between the vagina and anal canal.
conclusionsThe medial region between the vagina and anal canal in those giving birth includes a skeletal muscle complex formed by the confluence of the external anal sphincter, anterior bundle of the levator ani, and superficial transverse perineal muscle. In cases of severe perineal lacerations, these muscles could be injured. The anatomical knowledge that a part of the levator ani forms a muscle sling anterior to the anal canal is particularly important for obstetricians and gynecologists repairing obstetric lacerations and treating pelvic floor disorders.
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Registered trials
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