Perineal body !
The perineal body is a firm knot of muscle and fibrous tissue between the vagina and the anus; it anchors the pelvic floor and can tear in childbirth.
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What it is
A firm knot of muscle and connective tissue between the vaginal opening and the anus, where several perineal muscles meet.
What it does
Anchors the pelvic floor and supports the back wall of the vagina. It is what tears in a perineal tear and what an episiotomy cuts.
Key facts
- Where
- Fibromuscular node in the midline between the vaginal vestibule and the anus
- Attaches
- Bulbospongiosus, superficial and deep transverse perineal muscles, external anal sphincter, pubovaginalis/levator ani, perineal membrane, rectovaginal septum
- Function
- Central anchor of the perineum and support of the posterior vaginal wall; torn in 2nd-degree tears and cut in mediolateral episiotomy
Relations
- In front
- The vaginal orifice and fourchette, with the bulbospongiosus arising from it
- Behind
- The anal canal and the external anal sphincter
- Lateral
- The superficial and deep transverse perineal muscles, running to the ischial tuberosities
- Above
- The rectovaginal septum and the medial fibres of levator ani
- Superficial
- The skin of the perineum between the fourchette and the anus
How to find it
Felt as a firm, resilient mass in the midline between the fourchette and the anus. Its thickness is judged between a finger in the vagina and a thumb on the perineum; after a birth a rectal examination checks whether the anal sphincter is intact.
On imaging
Endoanal and transperineal ultrasound show it as a midline mass between the vagina and the anal canal, with the external anal sphincter just behind. After a perineal tear the classic finding is a gap in the sphincter ring, often with a thinned perineal body. MRI, especially with an endoanal coil, shows the same layers in more detail. Radiographs have no role.
Common problems
- Perineal tears in vaginal birth (first to fourth degree, depending on depth).
- Pain or poor healing after a tear or an episiotomy.
How it is diagnosed
Careful examination right after birth, including the anal sphincter; follow-up visit.
Treatment
- Layer-by-layer repair of tears with absorbable stitches.
- Pelvic floor physiotherapy after birth.
Clinical notes
- Obstetric anal sphincter injury (3rd and 4th degree) can lead to faecal incontinence or a rectovaginal fistula if missed
- Repair rebuilds the perineal body by joining the torn ends of the bulbospongiosus and transverse perineal muscles
- Male: it lies between the bulb of the penis and the anus; it is divided in the perineal approach to the prostate
Development
It marks the spot where the urorectal septum reached the cloacal membrane and split the cloaca into the urogenital sinus in front and the rectum and anal canal behind. If that division fails, a fistula or a single common channel (persistent cloaca) remains.
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
Which structures are involved in each degree of perineal tear?
1st: skin and vaginal lining; 2nd: perineal muscles and perineal body; 3rd: anal sphincter (3a–3c); 4th: also the anal lining.
Why is an episiotomy made mediolateral rather than in the midline?
A midline cut extends through the perineal body into the anal sphincter more often.
What are the consequences of losing or poorly repairing the perineal body?
The perineum weakens: gaping introitus, rectocele and prolapse.
Which muscles meet at the perineal body?
Bulbospongiosus, superficial and deep transverse perineal muscles, external anal sphincter and medial fibres of levator ani.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- corpus perineale TA2 2398
- Official Spanish (DeCS)
- Cuerpo perineal DeCS D010502
- English (TA2)
- Perineal body
- Also called
- perineal center · perineal centre · central tendinous point · centrum tendineum perinei
Related
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Abdomen and Pelvis, Perineal Body; Anatomy of the Human Body (20th ed.): The Digestive Apparatus (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain; Anatomy of the Human Body (20th ed.): Surface Markings of the Perineum (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.
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Representative model, for educational purposes only.
