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Figures in Case Report by Peter Petros(*) - Michael Swash(**)

(*) Royal Perth Hospital, University of Western Australia
(**) Dept of Neurology, The Royal London Hospital, London, UK

The Musculo-Elastic Theory of anorectal function and dysfunction


(Fig. 1)

 

Perineal incision

Figure 1. Bladder neck and anorectal closure. The same directional muscle forces contract against the suspensory ligaments PUL (pubourethral ligament) and USL(uterosacral) to create bladder neck and anorectal closure. Schematic 3D representation with the anorectal angle in the closed position. The middle part of pubococcygeus muscle has been cut away to reveal the underlying puborectalis muscle (PRM). Arrows=directional muscle forces. PCM= anterior portion of pubococcygeus muscle; LP=levator plate; LMA=longitudinal muscle of the anus; PS=pubic symphysis; S-sacrum; U=uterus; A=anus; V=vagina; R=rectum. The bladder is represented by dotted lines. (Petros,4 by permission, Int J Urogynecol).

 

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