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MALE PERINEUMMALE PERINEUMLECTURE BYLECTURE BY

PROF. ANSARIPROF. ANSARI

Thursday, April 20, 2023Thursday, April 20, 2023..

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BOUNDARIES OF PERINEUMBOUNDARIES OF PERINEUM

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Anterior triangle of perineumAnterior triangle of perineum

It is also called as urogenital triangle.It is also called as urogenital triangle. In male,it contains male external genitalia, In male,it contains male external genitalia,

perineal muscles and perineal pouches.perineal muscles and perineal pouches. In females,female external genitalia,perineal In females,female external genitalia,perineal

muscles and pouches are the contents. muscles and pouches are the contents.

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Female urogenital triangleFemale urogenital triangle

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SS

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The Colles’ fasciaThe Colles’ fascia

The Colles’ fascia is The Colles’ fascia is the extension of the extension of superficial fascia from superficial fascia from ant. Abdominal wall ant. Abdominal wall getting attached to getting attached to pubic symphysis,pubic pubic symphysis,pubic tubercles,conjoint tubercles,conjoint ischiopubic rami, and ischiopubic rami, and free border of peineal free border of peineal membrane.membrane.

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The posterior triangle is the anal The posterior triangle is the anal triangletriangle

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The deep perineal pouch is the The deep perineal pouch is the space between perineal space between perineal

membrane and superior fascia of membrane and superior fascia of urogenital diaphragmurogenital diaphragm

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The perineal muscles of maleThe perineal muscles of male

Superficial transverse perineii muscle,Superficial transverse perineii muscle, Deep transverse perineii muscle,Deep transverse perineii muscle, Bulbospongiosus,Bulbospongiosus, Ischiocavernosus,Ischiocavernosus, Sphincter ani externus,Sphincter ani externus, Perineal body,Perineal body, Sphincter urethrae,Sphincter urethrae, Pelvic diaphragm.Pelvic diaphragm.

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The bulbospongiosus on contraction expels The bulbospongiosus on contraction expels

last/final drops of urine & semenlast/final drops of urine & semen..

The ischiocacvernosus helps in fixing the root of The ischiocacvernosus helps in fixing the root of penis to get attached to the conjoint ischiopubic penis to get attached to the conjoint ischiopubic rami and also helps in erection of penis.rami and also helps in erection of penis.

The perineal body is a fibromuscular tendon The perineal body is a fibromuscular tendon formed by intersection of perineal muscles,helps in formed by intersection of perineal muscles,helps in supporting the pelvic organs.supporting the pelvic organs.

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Erection,emission & ejaculationErection,emission & ejaculation

The erection of penis is a parasympathetic The erection of penis is a parasympathetic activity, controlled by S2+3+4 segments.activity, controlled by S2+3+4 segments.

The emission of seminal fluid is due to the The emission of seminal fluid is due to the peristalsis of ductus deferens+seminal peristalsis of ductus deferens+seminal glands+prostatic fluid + and bulbourethral glands+prostatic fluid + and bulbourethral glands. Emission is a sympathetic response, glands. Emission is a sympathetic response, L1+L2 segments.L1+L2 segments.

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The ejaculation results fromThe ejaculation results from Closure of the internal urethral sphincter at Closure of the internal urethral sphincter at

the neck of the urinary bladder- sympathetic the neck of the urinary bladder- sympathetic response (L1+L2).response (L1+L2).

Contraction of the urethral muscle – Contraction of the urethral muscle – parasympathetic response (S2+S3+S4).parasympathetic response (S2+S3+S4).

Contraction of the bulbospongiosus Contraction of the bulbospongiosus muscles,Pudendal nerves (S2+3+4).muscles,Pudendal nerves (S2+3+4).

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The perineal nervesThe perineal nerves

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The perineal vesselsThe perineal vessels

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The nerves of the perineumThe nerves of the perineum

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Applied anatomyApplied anatomy

Extravasation of urine in to the superficial Extravasation of urine in to the superficial perineal pouch after injury and rupture of perineal pouch after injury and rupture of membranous urethra.membranous urethra.

Pudendal nerve block is done for surgery in Pudendal nerve block is done for surgery in the perineum region.the perineum region.

Injury to the perineal body leads to prolapse Injury to the perineal body leads to prolapse of rectum rectocele/bladder cyctocele/ and of rectum rectocele/bladder cyctocele/ and prolapse of uterus.prolapse of uterus.

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ThankThank