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.