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Burak G.G.1, Kim T.I.1, Buyanov I.V.2, Morgayeva Y.V.1
Perineology: anatomical-functional and clinical aspects. Part 1. Anatomy and functions of the anal region muscles
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk City Central Clinical Hospital, Vitebsk, Republic of Belarus

Vestnik VGMU. 2018;17(5):43-51.

Perineology is a complex branch of science that studies the development, structure and functions of the perineum in the norm and under various pathological conditions – congenital and acquired. In Russian and English literature, the complex of soft tissues covering the lower aperture of the pelvis is designated by two terms – «perineum» and «pelvic floor». Using these terms the authors describe the cutaneous-muscular-fascial formations, that are different in structure and function.
Our work gave grounds to call the complex of soft tissues occupying the space of exit from the small pelvis the «pelvic floor», and the cutaneous-muscular-fascial plate between the posterior wall of the labia major or the base of the scrotum and the tip of the coccyx – the «perineum». The results of the study will be presented in four articles, in which anatomy of the anal and urogenital areas of the pelvic floor will be described in detail.
In this article, we present the data on the muscles of the anal region obtained on the purposeful preparation of the corresponding area on the bodies of deceased people, on the preparation of museum specimens of the pelvic floor muscles, on analyzing literature data of the relevant content.
The description of individual anatomy of the anal part muscles of the pelvic floor has been provided in every particular. The priority is given to anatomy of the muscle that lifts the anus and the structural features of its three parts.
The anterior part of this muscle (the pubic-rectal muscle) is anatomically fused with the external sphincter of the anus, with the muscular covering of the rectum, which allows to consider it as the main functional unit responsible for all phases of defecation.
Anatomy of the anus sphincters and their participation together with the pubic-rectal muscle in the rectum closure system are also described.
Key words: pelvic floor, perineum, anal area muscles, pubic-rectal muscle, anus sphincters.


1. Tonkov VN. Textbook of normal human anatomy: ucheb dlia med in-tov. T 1. 5-e izd pererab i dop. Leningrad, RF: Medgiz Leningr otd-nie; 1953. 503 р. (In Russ.)
2. Kraev AV, Sinel'nikov RD, red. Human anatomy: ucheb posobie. V 2 t. T 1. Moscow, RF: Meditsina; 1978. 495 р. (In Russ.)
3. Uiliss KR. Atlas of pelvic surgery: per s angl. Moscow, RF: Med lit, 1999. 540 р. (In Russ.)
4. Salov PP. Pelvic floor and pelvic organ dysfunction. Novosibirsk, RF; 1998. 348 р. (In Russ.)
5. Ривкин ВЛ, Файн СН, Бронштейн АС, Ан ВК. Руководство по колопроктологии. Москва, РФ: Медпрактика-М Rivkin VL, Fayn SN, Bronshteyn AS, An VK. Guide to Coloproctology. Moscow, RF: Medpraktika-M; 2004. 488 р. (In Russ.)
6. Federative Committee on Anatomical Terminology. Terminologia anatomica: international anatomical terminology. Stuttgart: Georg Thieme Verlag; 1998. 300 р.
7. Borodinets AL, Rychagov GP, Nazarenko PM, Rusinovich VM, Ageev VP, Zabello TG, i dr. Modern tactics of treatment of acute paraproctitis. V: Problemy reabilitatsii proktologicheskikh bol'nykh: materialy 3-i mezhdunar konf. Minsk, RB; 1998. Р. 13-4. (In Russ.)
8. Bannister DzhDzh, Bartram KI, Berk M, Genri MM. Coloproctology and pelvic floor: pathophysiology and treatment. Moscow, RF: Meditsina; 1988. 464 р. (In Russ.)
9. Radzinskiy VE, Shalaev ON, Durandin YuM, Semyatov SM, Toktar LR, Salimova LYa. Perineology. Absolution and prolapse of genital organs: ucheb posobie. Moscow, RF: RUDN; 2008. 256 р. (In Russ.)
10. Aminev AM. Manual of proctology. T 3. Kuibyshev, RF; 1973. 536 р. (In Russ.)
11. Petrovskiy BV, gl red. Great medical encyclopedia. T 21: Prednisone-Solubility. Izd 3-e. Moscow, RF: Sovet entsikl; 1983. 560 р. (In Russ.)
12. Dul'tsev YuV, Salamov KN. Anal incontinence. Moscow, RF: Meditsina; 1993. 208 р. (In Russ.)
13. Wilson PM. Understanding the pelvic floor. S Afr Med J. 1973 Jul;47(26):1150-67.
14. Lawson JO. Pelvic anatomy. I. Pelvic floor muscles. Ann R Coll Surg Engl. 1974 May;54(5):244-52.
15. Lenyushkin AI. Children's Coloproctology: ruk dlia vrachei. Moscow. RF: Meditsina; 1990. 352 р.

Information about authors:
Burak G.G. – Candidate of Medical Sciences, associate professor of the Chair of Human Anatomy, Vitebsk State Order of Peoples’ Friendship Medical University.
Kim T.I. – senior lecturer of the Chair of Human Anatomy, Vitebsk State Order of Peoples’ Friendship Medical University;
Buyanov I.V. – head of the proctologic department, Vitebsk City Central Clinical Hospital;
Morgayeva Y.V. – the fourth-year medical student, Vitebsk State Order of Peoples’ Friendship Medical University.

Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Human Anatomy. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Tamara I. Kim.

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