Perineal Injury in Males | NIDDK
Physical examination was significant for a right scrotal induration and tenderness extending deep into the perineum sparing both testicles. In males, the perineum is the area between the anus and the scrotum, the external pouch of skin that holds the testicles. Injuries to the perineum can happen. The perineum is the region between the thighs inferior to the pelvic diaphragm. The male perineum includes the penis, scrotum, and the perineal muscles in the urogenital It's located where the labia minor meet at the front of the vulva.
The superficial layer is thick, loose, areolar in texture, and contains in its meshes much adipose tissue, the amount of which varies in different subjects.
In front, it is continuous with the dartos tunic of the scrotum; behind, with the subcutaneous areolar tissue surrounding the anus; and, on either side, with the same fascia on the inner sides of the thighs. The deep layer of superficial fascia fascia of Colles Fig. In the middle line, it is connected with the superficial fascia and with the median septum of the Bulbocavernosus. This fascia not only covers the muscles in this region, but at its back part sends upward a vertical septum from its deep surface, which separates the posterior portion of the subjacent space into two.
The Central Tendinous Point of the Perineum. At this point six muscles converge and are attached: It arises by tendinous fibers from the inner and forepart of the tuberosity of the ischium, and, running medialward, is inserted into the central tendinous point of the perineum, joining in this situation with the muscle of the opposite side, with the Sphincter ani externus behind, and with the Bulbocavernosus in front. In some cases, the fibers of the deeper layer of the Sphincter ani externus decussate in front of the anus and are continued into this muscle.
Occasionally it gives off fibers, which join with the Bulbocavernosus of the same side.
It may be absent or double, or insert into Bulbocavernosus or External sphincter. The anterior fibers, according to Tyrrel, also contribute to the erection of the penis by compressing the deep dorsal vein of the penis as they are inserted into, and continuous with, the fascia of the penis.
Proximal Corpus Cavernosum Tear Presenting as Scrotal Hematoma
The Ischiocavernosus Erector penis covers the crus penis. It is an elongated muscle, broader in the middle than at either end, and situated on the lateral boundary of the perineum. It arises by tendinous and fleshy fibers from the inner surface of the tuberosity of the ischium, behind the crus penis; and from the rami of the pubis and ischium on either side of the crus. An overview of sequences during the normal development of male external genitalia has been provided and the deranged mechanism resulting in this anomaly has been reviewed with hypothesis regarding etiology of accessory scrotum.
Introduction Accessory scrotum is considered the rarest of all congenital scrotal abnormalities [ 1 ]. Inaccessory scrotum, in addition to a normally developed scrotum, ectopic scrotal tissue is present either in the perineum or elsewhere, without the presence of testis within it [ 23 ]. An interesting case of accessory scrotum in the perineum with a perineal lipoma is reported with the relevant embryological basis for this condition, and hypotheses for the development of an accessory scrotum have been discussed.
Case Report A 1-year-old boy presented with a mass localized to the right inferior aspect of genitalia in the perineal region, another small swelling was attached to the undersurface of the mass Figure 1.
- Perineal Injury in Males
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- Acute perineum and scrotum: Cross-sectional imaging findings
Both mass and swelling were present since birth. Red arrow shows intervening lipoma and white arrow shows accessory scrotum. The penis and the primary scrotum were completely normal, were contained testes within the scrotum. The mass just below the scrotum was soft in consistency and freely mobile.
Perineal raphe - Wikipedia
The swelling attached below the mass was soft, rugose, and contained no discernable testis-like structures. The mass and swelling were surgically removed, and postoperative recovery was uneventful.
The histological examination revealed the mass as being lipoma, and the other swelling had rugose epidermis with hair follicles and rudimentary dartos fibers, so histopathological examination confirmed the diagnosis of accessory scrotum Figure 2. Arrow shows rudimentary dartos muscles. Discussion Accessory scrotum is an extremely rare abnormality.Testicular Cancer
Congenital scrotal anomalies are conventionally classified into four types: Bifid scrotum is a partial or complete separation of otherwise normally positioned hemiscrotum in patients with severe hypospadias or chordee.
In cases of penoscrotal transposition, part or whole of the scrotum is located superior to the penile shaft. Ectopic scrotum is ectopic positioning of the scrotum which is usually unilateral, with the ectopic tissue usually suprainguinal, but in some cases infrainguinal femoral or on the thigh. The ipsilateral testis is usually present within the ectopic hemiscrotum.