Sometimes, the stretching is too much and the
perineal muscles will tear, resulting in perineal tears.
Postsurgical prognosis is better in adult patients in whom the gluteal cleft is fully developed beside the sacrum and the normal gluteal muscle mass, the nerves are intact to maintain the anal reflex, and the voluntary
perineal muscles are visibly contractile (3).
5 cm and the patient is asked to contract her
perineal muscles.
Kegel or pelvic muscle exercises are discrete exercises that strengthen the
perineal muscles.
Six key structures may be involved in perineal injury: the anorectal mucosa, internal anal sphincter, external anal sphincter, vaginal wall and perineal skin, bulbocavernosus muscle, and transverse
perineal muscles.
3,4) Traditionally, the vagina is stitched using a continuous locking suture and the
perineal muscles and skin are repaired using intermittent sutures.
Perineal pain arises from perineal tears, inflammatory reaction, swelling of the adjacent tissues and the contractions of levator ani and other
perineal muscles.
Progressive resistance exercise in the functional restoration of the
perineal muscles.
A first-degree tear is an injury to the perineal skin only; a second-degree tear means injury to the
perineal muscles but not the anal sphincter; a third-degree tear also involves the anal sphincter complex; and a fourth-degree injury involves the anal sphincter complex and the anal epithelium.
Perineal hernias occur when the
perineal muscles separate, allowing rectal pelvic, and/or abdominal contents to displace perineal skin (Fossum et al.
Cruz Y, Hudson R, Pacheco P, Lucio RA, Martinez-Gomez M (2002) Anatomical and physiological characteristics of
perineal muscles in the female rabbit.
The pelvic floor is made up of a group of muscles and connective tissue that extends as a sling across the base of the pelvis; it comprises two layers, the superficial
perineal muscles and the deep pelvic diaphragm, and provides support for the pelvic organs, the bladder and elements of the spine.
