Anatomy of the perineal membrane as seen in magnetic resonance images of nulliparous women

Catherine J Brandon, Christina Lewicky-Gaupp, Kindra A Larson, John O L Delancey
American Journal of Obstetrics and Gynecology 2009, 200 (5): 583.e1-6

OBJECTIVE: Recent cadaver research demonstrates the perineal membrane's ventral and dorsal portions and close relationship to the levator ani muscle. This study seeks to show these relationships in women by magnetic resonance (MR) images.

STUDY DESIGN: The subjects were 20 asymptomatic nulliparous women with normal pelvic examinations. MR images were acquired in multiple planes. Anatomical relationships from cadaver studies were examined in these planes.

RESULTS: In the coronal plane the ventral perineal membrane forms an interconnected complex with the compressor urethrae, vestibular bulb, and levator ani. The dorsal part connects the levator ani and vaginal side wall via a distinct band to the ischiopubic ramus. In the sagittal plane the parallel position of perineal membrane and levator ani are seen.

CONCLUSION: The perineal membrane's anatomical features can be seen in women with MR. The close relationship between the perineal membrane and levator ani is evident.

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