Levator anus muscles

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Levator ani

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Levator Ani Syndrome: Symptoms, Causes, and Treatment

The authors state that the levator ani has a transverse portion and a vertical portion and that the puborectalis muscle is a u-shaped muscle outside the vertical portion. Based on those findings, the authors conclude that the puborectalis is not a part of the levator ani muscle. The concept that the puborectalis muscle is anatomically a part of the external anal sphincter muscle, rather than the levator ani muscle has been previously proposed from a cadaver study. Although the puborectalis and external anal sphincter muscle form a functional unit in maintaining continence, developmental studies provide evidence that the puborectalis is anatomically a part of the levator ani muscle.
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Understanding Levator Ani Syndrome

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STUDY DESIGN: Detailed dissections of the peripheral innervation of the iliococcygeal, pubococcygeal, puborectal, and coccygeal muscles were performed in 12 fresh-frozen female cadavers aged, years with the use of transabdominal, gluteal, and perineal approaches. Both the pudendal nerve and the sacral nerve roots that enter the pelvis from the cephalic side were followed from their origin at the sacral foramina to their termination. Pelvic floor innervation was described with reference to fixed bony landmarks, particularly the coccyx, the ischial spine and the inferior pubis.
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