Anatomical Terminology: The Perineum
The space between the rectum and testicles is called the perineum. This is the standard anatomical term used in clinical practice and medical literature to describe this region.
Anatomical Definition and Boundaries
The perineum is a diamond-shaped area that extends from the pubic symphysis anteriorly to the coccyx posteriorly, and laterally to the ischial tuberosities 1. This region contains multiple fascial layers and potential spaces that are clinically significant for understanding disease spread and surgical planning.
Key Anatomical Structures Within the Perineal Region
The perineum contains several important anatomical spaces and structures:
Superficial perineal space: Bounded by Colles fascia (continuation of Scarpa's fascia from the abdominal wall) and contains the superficial perineal muscles and neurovascular structures 1
Ischiorectal (ischioanal) fossa: The largest space in the anorectal region, located lateral to the anal canal and rectum, bounded by the levator ani muscle superiorly and the external anal sphincter medially 2, 3, 4
Intersphincteric space: Located between the internal and external anal sphincters, representing a critical anatomical plane for perianal disease 2, 5
Clinical Significance
Understanding perineal anatomy is essential for recognizing disease patterns:
Fournier's gangrene: A necrotizing soft tissue infection that can spread through the perineal fascial planes, extending from the perineum up to the abdominal wall via Scarpa's fascia or down to the thighs 2, 1
Perianal abscesses and fistulae: These commonly involve the perineal spaces, with the ischiorectal fossa being a frequent site of abscess formation 2, 6
Fascial continuity: The dartos, Buck's, Colles, and Scarpa fasciae form continuous planes that allow disease to spread from the perineum to the scrotum, penis, and anterior abdominal wall 1
The term "perineum" is universally recognized in medical practice and should be used when documenting physical examination findings, describing surgical approaches, or discussing pathology in this anatomical region 2, 1.