Perineum: Superficial and Deep Perineal Pouches

Introduction

The perineum is a crucial anatomical region that plays a key role in various physiological functions, including excretion and reproduction. This article explores the neurovascular supply of the perineum, highlighting the superficial and deep perineal pouches.

Neurovascular Supply of the Perineum

Arterial Supply

The perineum receives its arterial blood supply mainly from branches of the internal pudendal artery, including:

Inferior rectal artery
Perineal artery
Deep and dorsal arteries of the penis/clitoris

Venous Drainage

Venous drainage follows the arterial supply, involving the internal pudendal veins, which ultimately drain into the internal iliac vein.

Nerve Supply

The perineum's innervation is primarily via the pudendal nerve, originating from the sacral plexus. It provides motor and sensory control to the structures within the perineal region.

Superficial and Deep Perineal Pouches

Superficial Perineal Pouch

The superficial perineal pouch lies between the perineal membrane and Colles' fascia. It contains structures such as:

Bulbospongiosus muscle
Ischiocavernosus muscle
Superficial transverse perineal muscle
Branches of the pudendal nerve and vessels

Deep Perineal Pouch

Located above the perineal membrane, this pouch houses:

Deep transverse perineal muscles
External urethral sphincter
Internal pudendal vessels
Branches of the pudendal nerve

Clinical Significance

Understanding the neurovascular supply of the perineum is essential for diagnosing conditions such as perineal trauma, nerve compression syndromes, and vascular disorders. Additionally, surgical procedures in the perineal region, including episiotomies, require precise anatomical knowledge to prevent complications.

Conclusion

The perineum is an anatomically and functionally significant region with complex neurovascular structures. A thorough understanding of its superficial and deep perineal pouches enhances clinical assessments and surgical interventions.