[17] In one study, [15] however, there was no evidence found the sphincter defect in older women with thinner
perineal body. In some studies, there was no significant relationship between PBT and Wexner score, i.e.
at least a portion of the
perineal body to remain intact.
Perineal body defects (anal sphincter defect) and rectoceles are separate entities and treated differently.
View in the mirror to see that the
perineal body is pulled inward with the lift.
In my practice, when a patient complains of splinting or incomplete evacuation, I suspect a distal rectocele and a deficient
perineal body.
Perineal body defects are often found in patients who have an enlarged vaginal introitus or a history of straining or prior episiotomy, for instance, and addressing these defects is a key part of posterior wall repair that is too often neglected.
vagina 34 22.2 From vault to sacrum 7 4.6 Posteriorly from mid-vagina to sacrum 27 17.6 Posteriorly from
perineal body to sacrum 119 77.8 2.
Three other measurements are taken: the vaginal length at rest, the genital hiatus (gh) from the middle of the urethral meatus to the posterior hymenal ring and the
perineal body (pb) from the posterior aspect of the genital hiatus to the midanal opening.
I often trim a bit of the mesh at the distal end and then place that end in the rectovaginal space to ensure its proximity to the apex of the
perineal body. Again, I close the incision with a running interlocking stitch and use vaginal packing for 24 hours.
Eighty-four patients (54.6%) had an obviously deficient
perineal body. In 61 patients (39.6%) the uterus was still intact.
Some techniques in the surgical literature describe correction of a defect between the distal rectovaginal septum and the apical
perineal body. Damage to the perineum is either a laceration or an iatrogenic episiotomy.
Consensus is lacking on what the minimal length of a vagina must be to preserve normal sexual function, and no standard exists in regards to either normal vaginal caliber or the relationship of the perineum and
perineal body to the distal posterior vagina.
Grody has raised compelling issues, especially in regard to the importance of the
perineal body in pelvic floor prolapse.