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Surgical and Radiologic Anatomy
Published in: Surgical and Radiologic Anatomy 9/2017

01-09-2017 | Original Article

Morphology of the region anterior to the anal canal in males: visualization of the anterior bundle of the longitudinal muscle by transanal ultrasonography

Authors: Yasuo Nakajima, Satoru Muro, Hisayo Nasu, Masayo Harada, Kumiko Yamaguchi, Keiichi Akita

Published in: Surgical and Radiologic Anatomy | Issue 9/2017

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Abstract

Purpose

The anterior bundle of the longitudinal muscle in the region anterior to the anal canal in males has been described, although the anatomical details remain unclear. The present study was undertaken to clarify the precise morphology of the anterior bundle of the longitudinal muscle and its relationship to the surrounding structures, and to visualize the anterior bundle of the longitudinal muscle via transanal ultrasonography.

Methods

Histological examination was carried out using seven male cadavers; an additional three male cadavers were used for transanal ultrasonography, and the ultrasonography images were compared with the actual sagittal sections. In addition, transanal ultrasonography images of 50 male patients at Tokatsu-Tsujinaka Hospital were studied.

Results

The region anterior to the anal canal consisted of smooth muscles and skeletal muscles. The anterior bundle of the longitudinal muscle was situated between the bulbospongiosus and the external anal sphincter, and consisted of smooth muscle. The bundle was identified in the transanal ultrasonography of cadavers by comparison with the actual sections. Transanal ultrasonography images of living bodies showed the anterior bundle of the longitudinal muscle as a hypoechoic layer of approximately 17.7 mm in length.

Conclusions

The detailed anatomical findings of the anterior bundle of the longitudinal muscle suggested “an alternate arrangement of smooth muscles and skeletal muscles” in the region anterior to the anal canal and facilitated the visualization of the anterior bundle of the longitudinal muscle in transanal ultrasonography.
Literature
1.
Aigner F, Zbar AP, Ludwikowski B, Kreczy A, Kovacs P, Fritsch H (2004) The rectogenital septum: morphology, function, and clinical relevance. Dis Colon Rectum 47:131–140CrossRefPubMed
2.
3.
Beets-Tan RG, Morren GL, Beets GL, Kessels AG, el Naggar K, Lemaire E, Baeten CG, van Engelshoven JM (2001) Measurement of anal sphincter muscles: endoanal US, endoanal MR imaging, or phased-array MR imaging? A study with healthy volunteers. Radiology 220:81–89. doi:10.​1148/​radiology.​220.​1.​r01jn1481 CrossRefPubMed
4.
Brooks JD, Chao WM, Kerr J (1998) Male pelvic anatomy reconstructed from the visible human data set. J Urol 159:868–872CrossRefPubMed
5.
Burnett AL, Mostwin JL (1998) In situ anatomical study of the male urethral sphincteric complex: relevance to continence preservation following major pelvic surgery. J Urol 160:1301–1306CrossRefPubMed
6.
Gerdes B, Kohler HH, Zielke A, Kisker O, Barth PJ, Stinner B (1997) The anatomical basis of anal endosonography. A study in postmortem specimens. Surg Endosc 11:986–990CrossRefPubMed
7.
8.
Matsubara A, Murakami G, Arakawa T, Yasumoto H, Mutaguchi K, Akita K, Asano K, Mita K, Usui T (2003) Topographic anatomy of the male perineal structures with special reference to perineal approaches for radical prostatectomy. Int J Urol 10:141–148CrossRefPubMed
9.
Murad-Regadas SM, Regadas FS, Rodrigues LV, Holanda Ede C, Barreto RG, Oliveira L (2010) The role of 3-dimensional anorectal ultrasonography in the assessment of anterior transsphincteric fistula. Dis Colon Rectum 53:1035–1040. doi:10.​1007/​DCR.​0b013e3181dce163​ CrossRefPubMed
10.
Muro S, Yamaguchi K, Nakajima Y, Watanabe K, Harada M, Nimura A, Akita K (2014) Dynamic intersection of the longitudinal muscle and external anal sphincter in the layered structure of the anal canal posterior wall. Surg Radiol Anat SRA 36:551–559. doi:10.​1007/​s00276-013-1228-8 CrossRefPubMed
11.
Myers RP, Cahill DR, Devine RM, King BF (1998) Anatomy of radical prostatectomy as defined by magnetic resonance imaging. J Urol 159:2148–2158CrossRefPubMed
12.
13.
14.
Smith GE (1908) Studies in the anatomy of the pelvis, with special reference to the Ffasciae and visceral supports: Part I. J Anatomy Physiol 42:198–218
15.
Soga H, Takenaka A, Murakami G, Fujisawa M (2008) Topographical relationship between urethral rhabdosphincter and rectourethralis muscle: a better understanding of the apical dissection and the posterior stitches in radical prostatectomy. Int J Urol 15:729–732. doi:10.​1111/​j.​1442-2042.​2008.​02096.​x CrossRefPubMed
16.
Takenaka A, Murakami G, Matsubara A, Han SH, Fujisawa M (2005) Variation in course of cavernous nerve with special reference to details of topographic relationships near prostatic apex: histologic study using male cadavers. Urology 65:136–142. doi:10.​1016/​j.​urology.​2004.​08.​028 CrossRefPubMed
17.
Tsukada Y, Ito M, Watanabe K, Yamaguchi K, Kojima M, Hayashi R, Akita K, Saito N (2016) Topographic anatomy of the anal sphincter complex and levator ani muscle as it relates to intersphincteric resection for very low rectal disease. Dis Colon Rectum 59:426–433. doi:10.​1097/​dcr.​0000000000000565​ CrossRefPubMed
18.
Wu Y, Dabhoiwala NF, Hagoort J, Shan J-L, Tan L-W, Fang B-J, Zhang S-X, Lamers WH (2015) 3D Topography of the young adult anal sphincter complex reconstructed from undeformed serial anatomical sections. PloS One 10:e0132226CrossRefPubMedPubMedCentral
19.
Zhai LD, Liu J, Li YS, Ma QT, Yin P (2011) The male rectourethralis and deep transverse perineal muscles and their relationship to adjacent structures examined with successive slices of celloidin-embedded pelvic viscera. Eur Urol 59:415–421. doi:10.​1016/​j.​eururo.​2010.​11.​030 CrossRefPubMed
Metadata
Title
Morphology of the region anterior to the anal canal in males: visualization of the anterior bundle of the longitudinal muscle by transanal ultrasonography
Authors
Yasuo Nakajima
Satoru Muro
Hisayo Nasu
Masayo Harada
Kumiko Yamaguchi
Keiichi Akita
Publication date
01-09-2017
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 9/2017
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-017-1832-0

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