Fig. i6o. Female Perineum. 



Body of a Young Female. The skin and Superficial Fascia, except of the Mons 

 Veneris, have been removed On the right side the superficial, on the left side 

 the deep layer of the Perinetim is shewn: on both sides the Os Innominatum 

 is exposed: on the right the Great Sacra-Sciatic Ligament is preserved. Vessels 

 and Nerves are entirely preserved on the right side, but only partly on the left. 



The chief difference between the Male and Female Perineum consists in 

 the following : — 



Instead of the small urethral aperture in the triangular ligament of the Male, 

 there exists in the Female, a inuch wider opening for the Vestible. Whereas 

 the Corpora Spongiosa are joined in the Male to form the Corpus Spongiosum, 

 the corresponding parts in the Female remain distinct, as the Bulb of the Vesti- 

 bule. So that the Bulbo-cavernosus Muscles in the Female remain distinct on 

 either side: whereas in the Male, they come together in a median raphe. A 

 connection of the superficial fibres of the Bulbo-Cavernosus, with the Sphincter 

 Ani (like a figure 8), is likewise present in the Female. The Bulbs lie on either 

 side of the Vestibule at the base of the Labia Minora. These Bulbs of the A'esti- 

 bule contain large quantities of Blood, so that injury to them (e. g. during labour), 

 may produce serious haemorrhage. From these there extends forwards a Venous 

 Plexus which, near the Frenum of the Clitoris, passes into the deeper tissues 

 at the side of the Clitoris communicating at its mesial aspect with the Veins of 

 the Clitoris (particularly those of the Glans of the Clitoris). The Corpora Caver- 

 nosa of the Clitoris are much smaller than the Bulbs of the Vestibule or of the 

 corresponding parts in the Male. The}' arise from the descending Ramus of tlie 

 Pubis on either side, and unite under the Suspensory Ligament to form one shaft 

 (divided by an imperfect septum); the Clitoris is curved with its concavity 

 downwards and backwards, so that its extremit}', the Glans, points towards the 

 Vestibule. Many minute veins of the Glans unite to form the Dorsal Vein of the 

 Clitoris, which opens under the Suspensory Ligament into the Pubic Plexus. 

 (Cf. Male.) 



The Bulb of the Vestibule having a position different from the corre- 

 sponding parts in the male, the glands, corresponding to CowPER's Glands, i. e. 

 Bartholixi's Glands lie internally and behind the Bulbus Vestibuli. 



The Pubic Arch being much wider, and the Ischio-Cavernosus Muscle 

 less developed in the Female, the Urogenital Triangle is larger than in the Male. 

 In Virgins, the muscles in the subpubic region are well developed. During labour. 

 the Vestible and surrounding parts are stretched to a maximum and even fre- 

 quently torn, so that a perfect restitution to the normal state never occurs. The 

 ^'^estibule and neighbouring parts remain stretched after labour, so that the 

 muscles become .smaller and degenerated, or replaced by connective tissue and fat. 



The "True Perineum" which lies between the Vestibule and Vagina in 

 front, the Anus and Rectum behind, is neither broad nor strong. "Rupture of the 

 Perineum" is therefore a frequent occurrence during labour. It falls to the duty 

 of the Obstetrician and Gynaecologist, to prevent this rupture by appropriate 

 mechanical intervention, to detect injuries and to suture them, and to cure Recto- 

 ^'aginal Fistulae. 



