The fibrous tissue architecture of the female perineal region.

In relation to the question which type of episiotomy should be preferred, the subcutaneous layer of the anatomical perineum of three adult female subjects was bluntly dissected. In the urogenital triangle constantly five fibrous septa were observed, and in the posterior (anal) triangle several antero-posterior septa as well as septa radiating from the walls of the anal canal and the vagina. In addition, dense connective tissue structures overly the ischial tuberosity. Microscopical studies showed that all septa contain blood vessels and bundles of smooth muscle fibres. Only the dorsal, median septum which connects the anal canal to the coccyx, contains bundles of striated muscle fibres, too. The results show that only the median episiotomy leaves the system of subcutaneous perineal fibrous tissue septa unimpaired.