The second U-shaped incision was made on the posterior commissure of the bulbospongiosus muscles (Figure 1).
Although the small sample size and absence of long-term results were limitations of this study, the satisfactory preliminary results encourage us to consider that combined repair of anal sphincters, perineal body, superficial transverse perinei muscles, and bulbospongiosus muscles may improve surgical outcomes in patients with OASIS.
When the bladder has emptied, the bulbospongiosus
muscles contract to expel urine that remains in the urethra, and these contractions increase pressure within the CSP and may prevent healing of a urethral lesion that communicates with the CSP.
Moreover, tissue, including the bulbospongiosus
muscle, is left intact over the urethra, serving as a cushion between the urethra and the sling and further minimizing the risk of erosion.
urethra is then exposed (see Figure 4).
In most women, this incision cuts a portion of the bulbospongiosus
muscle and, occasionally, reaches the ischioanal fossa.
Blood drainage from the penis is done by external pudendal vein and internal pudendal vein and venous blood in deep vein penis, bulbar vein and dorsal penile vein enter to internal pudendal vein and then internal iliac and finally coudal vena cava, and the external pudendal vein blood prepuce, skin, corpus spongiosum penis and ischiocavernosus, bulbospongiosus
and retractor muscles and free part penis through dorsal vein drainage (Fig7,8).
(5,8) The perineal nerve supplies motor innervations to the pelvic floor muscles (transverse perineal muscles, bulbospongiosus
, ischiocavernosus, sphincter urethra and the levator ani muscles).
The ischiocavernosus (see Figure 5-2) and bulbospongiosus
muscles lie lateral and dorsal to the base of the penis, respectively.
The entry of fluids into the urethra stimulates other sensory neurons which enter the central nervous system and ultimately activate parasympathetic efferents that innervate the bulbospongiosus
muscle, ischiocavernosus muscle, and muscles of the pelvic floor.