[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Pelvis](https://durgical.com/en/anatomy/region/pelvis/) › Perineal body [Muscular system](https://durgical.com/en/anatomy/system/muscular-system/) · [Pelvis](https://durgical.com/en/anatomy/region/pelvis/) # Perineal body The perineal body is a firm knot of muscle and fibrous tissue between the [vagina](https://durgical.com/en/anatomy/vagina/) and the anus; it anchors the pelvic floor and can tear in childbirth. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=pelvis&select=perineal_body&side=r) Opens in the Durgical app, no sign-up needed. ## 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 points - Perineal tears: 1st degree skin and vaginal lining; 2nd perineal muscles and perineal body; 3rd the anal sphincter (3a, 3b, 3c by depth); 4th also the anal lining - Mediolateral episiotomy is angled away from the midline because a midline cut extends into the anal sphincter more often - Superficial perineal pouch: below the [perineal membrane](https://durgical.com/en/anatomy/perineal-membrane/), with the erectile tissue, its muscles and the [Bartholin glands](https://durgical.com/en/anatomy/greater-vestibular-gland/); deep pouch: above it, with the [external urethral sphincter](https://durgical.com/en/anatomy/female-external-urethral-sphincter/) - If it is lost or poorly repaired, the whole perineum weakens: gaping introitus, rectocele and prolapse ## 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](https://durgical.com/en/anatomy/bulbospongiosus-muscle/) arising from it **Behind** The [anal canal](https://durgical.com/en/anatomy/anal-canal/) and the [external anal sphincter](https://durgical.com/en/anatomy/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](https://durgical.com/en/anatomy/levator-ani/) **Superficial** The [skin](https://durgical.com/en/anatomy/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](https://durgical.com/en/anatomy/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](https://durgical.com/en/anatomy/rectum/) and anal canal behind. If that division fails, a fistula or a single common channel (persistent cloaca) remains. ## Related conditions - [Obstetric perineal tears and anal sphincter injury](https://durgical.com/en/conditions/obstetric-perineal-tears-and-anal-sphincter-injury/) ## 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. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/perineal-body/) 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 - [External anal sphincter](https://durgical.com/en/anatomy/external-anal-sphincter/) - [Pudendal nerve](https://durgical.com/en/anatomy/pudendal-nerve/) - [Internal pudendal artery](https://durgical.com/en/anatomy/internal-pudendal-artery/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=10693); [Anatomy, Abdomen and Pelvis, Perineal Body](https://www.ncbi.nlm.nih.gov/books/NBK537345/); 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. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/perineal-body/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/perineal-body/