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BioMed Research International
Volume 2014, Article ID 906921, 18 pages
http://dx.doi.org/10.1155/2014/906921
Review Article

The Urethral Rhabdosphincter, Levator Ani Muscle, and Perineal Membrane: A Review

1Department of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
2Department of Anatomy, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba 261-8502, Japan
3Division of Internal Medicine, Iwamizawa Kojin-kai Hospital, 297-13 Shibun-cho, Iwamizawa 068-0833, Japan

Received 26 October 2013; Revised 4 March 2014; Accepted 5 March 2014; Published 27 April 2014

Academic Editor: Roberto Miano

Copyright © 2014 Nobuyuki Hinata and Gen Murakami. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Detailed knowledge of the anatomy of the rhabdosphincter and adjacent tissues is mandatory during urologic surgery to ensure reliable oncologic and functional outcomes. To characterize the levator ani (LA) function for the urethral sphincter, we described connective tissue morphology between the LA and urethral rhabdosphincter. The interface tissue between the LA and rhabdosphincter area in males contained abundant irregularly arrayed elastic fibers and smooth muscles. The male rhabdosphincter was positioned alongside the LA to divide the elevation force and not in-series along the axis of LA contraction. The male perineal membrane was thin but solid and extends along the inferior margin or bottom of the rhabdosphincter area. In contrast, the female rhabdosphincter, including the compressor urethrae and urethrovaginal sphincter muscles, was embedded in the elastic fiber mesh that is continuous with the thick, multilaminar perineal membrane. The inferomedial edge of the female LA was attached to the upper surface of the perineal membrane and not directly attached to the rhabdosphincter. We presented new diagrams showing the gender differences in topographical anatomy of the LA and rhabdosphincter.