Morphologies of the interfaces between the levator ani muscle and pelvic viscera, with special reference to muscle insertion into the anorectum in elderly Japanese

Anatomical Science International
Takashi ArakawaTatsuo Teramoto

Abstract

A specific, smooth muscle-mediated interface between the levator ani muscle (LA) and the pelvic viscera has been reported. Using 110 sagittally trimmed anorectal tissue strips (80 lateral, 15 anterior and 15 dorsal specimens) obtained from the donated cadavers of 46 elderly subjects, we examined variations in the interface between the LA and the rectal muscularis propria, including the so-called conjoined longitudinal muscles. In type A (9/46), little or no tissue connected the LA to the external rectal muscularis propria, but the LA and external sphincteric mass formed a definite complex. In type B (26/46), the covering fascia of the LA changed abruptly into smooth muscles, which merged into the external rectal muscularis propria. In type C (11/46), most of the LA-associated connective tissues, composed of smooth muscles, were tightly connected to the internal and external rectal muscularis propria. These variations seemed to depend on the morphology of the recto-urethralis, the lateral extension of which reinforced the LA-associated smooth muscles sufficiently to form type B and C insertions. We also demonstrated differences in the interfacial tissues between the LA and other pelvic viscera. We hypothesize that, to avoid inju...Continue Reading

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Citations

Mar 3, 2007·International Urogynecology Journal and Pelvic Floor Dysfunction·Ichiro NagataAiji Ohtsuka
Jun 15, 2007·International Urogynecology Journal and Pelvic Floor Dysfunction·Hideo SogaMasayasu Koyama
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Nov 30, 2015·International Journal of Colorectal Disease·Takashi ArakawaBaik Hwan Cho
Sep 18, 2015·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Zhe Wu JinShin-Ichi Abe
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Mar 21, 2013·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Keisuke HiedaAkio Matsubara
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May 19, 2020·Anatomical Science International·Mayumi Kobayashi KatoKeiichi Akita

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