The perineum is made up of a set of soft tissues and musculo-fascial formations, arranged on three levels, forming a sort of "network" that closes the abdominal and pelvic cavity. The structure thus organized is crossed by the terminal part of the digestive system, posteriorly (anal or anorectal perineum), and by the urinary tract and genitals, anteriorly (urogenital perineum).
The perineum performs various functions: the most important task is performed by the muscles and consists in supporting the internal organs (bladder, uterus and rectum). This region also contributes to urinary and fecal continence, plays an important role in sexual life and, during childbirth, supports the release of the unborn child.
Given its particular position, the perineum can be involved in trauma, inflammation and various other pathological processes in both men and women.
(lying on the back), with flexed and widened thighs.
From the anatomical point of view, the perineum is a "rhomboid-shaped area, delimited at the top by the pubic symphysis, at the bottom by the coccyx and laterally by the two ischial tuberosities.
If an ideal line is drawn from one ischial tuberosity to the other, in the perineal region we can distinguish:
- An anterior portion (or urogenital region, containing the vagina in the woman and the scrotum in the man);
- A posterior portion (or anal region).
As a whole, the perineum consists of:
- Skin rich in sebaceous and sweat glands, covered with hair after pubertal age;
- Subcutaneous connective tissue;
- Muscles: the main ones are the external sphincter of the urethra, the sphincter of the anus, the levator anus and the ischium-coccygeal. Together with the ligaments and the aponeurotic bands they contribute to the statics and dynamics of the perineum, therefore and stabilize the pelvic organs (intestine, uterus and bladder);
- Aponeurosis: envelop the muscles, contributing to the closure of the lower strait of the pelvis. In the perineum, the musculo-aponeurotic planes are three:
- Superficial perineal aponeurosis;
- Middle perineal aponeurosis;
- Deep perineal aponeurosis or pelvic fascia.
The muscles of the perineum constitute the so-called "pelvic floor", a sort of very robust "network" on which the bladder, uterus and intestine rest; the ligaments participate giving stability to the system.
