What Is the Pubococcygeus Muscle?

The pubis muscle refers to the muscles below the femoral trochanter. A muscle in the thigh muscles. This muscle is a rectangular short muscle, which is located in the subcutaneous area on the upper and middle front of the thighs, the medial side of the iliopsoas, and the lateral side of the long adductor muscles, starting from the pubic osteoporosis and the suprapubic branch and ending at the pubic line below the femoral trochanter.

The pubis muscle refers to the muscles below the femoral trochanter. A muscle in the thigh muscles. This muscle is a rectangular short muscle, which is located in the subcutaneous area on the upper and middle front of the thighs, the medial side of the iliopsoas, and the lateral side of the long adductor muscles, starting from the pubic osteoporosis and the suprapubic branch and ending at the pubic line below the femoral trochanter.

Chinese name

Pubic muscle

Foreign name

petineal muscle

Physiological anatomy of the pubic muscle

The pubic muscle is dominated by the femoral nerve branch (occasionally by the branch of the obturator nerve), and the thigh flexes, adducts, and pronation when contracted. When this muscle contracts, it causes the thigh to flex, adduct, and externally rotate. The pubic muscle is innervated by the branches of the femoral nerve.

Pubic muscle trigger position

1. Starting point: in front of the pubic and sciatic branches.

2. Stop: femoral condyle.

3. Trigger point position: the distal end above the pubic branch.

4. Pain Involved: Deep Pain Under the Inguinal Ligament

The concept and clinical significance of the pubic muscle

The pubic muscle hole is an oval-shaped fissure in the lower abdominal wall that connects to the pelvis. The upper boundary is the external oblique and transverse abdominal muscles, the lower boundary is the pubic comb ligament, the medial rectus abdominis, and the lateral iliopsoas. The pubic muscle hole is separated by the inguinal ligament located in the front and the zygomatic humerus in the back. It is divided into upper and lower areas. The upper area has the oblique hernia triangle (sperm cord, inner ring) and the straight hernia triangle. , Nerve and oval fossa, which has pit ligament protection). Lichtenstein and other abdominal transverse fascia anterior plain film repairs (onlay) actually only cover the pubic muscle hole, the upper area (ie, the bottom of the groin box), repair of oblique and straight hernia areas, and does not involve repairing the lower part of the pubic muscle hole Area (ie the triangle area). In other words, plain film repair only repairs most of the weak areas of the pubic muscle foramen. For male inguinal hernia patients, plain film repair still has certain clinical value. However, for female patients or patients with a tendency to develop femoral hernias, it is not enough to repair the suprapubic muscle foramen (inguinal box).

However, the research on the pubic pores is far from the understanding of the inguinal canal, inner and outer rings (inguinal box), and there is no unified opinion on how large a patch is used to repair the pubic pores. We measured the pubic muscle foramen in 50 patients with inguinal hernia, and the results showed that their average length and width were 7.6 cm and 6.5 cm (to be published). Dong Jian and other national body specimens showed that the average length was 7.3 m and the average width was 5.7 cm. The data on the pubic myoforax of cadaver specimens carried out by Wolloscheck and other foreign countries4 are average length 7.6m and average width 7.6cm. The results of these studies indicate that the size of the pubic pores is not significantly different. Although Wolloscheck et al. Believe that a 10 cm x 8 cm patch is sufficient to cover the repair of the pubic muscle hole. We think that considering the slight contraction of the postoperative patch, a patch with a size slightly larger than the actual measured data should be selected.

Repairing the weak areas of the pubic muscle foramen is often performed by placing the patch in front of the peritoneum, that is, the patch is located between the abdominal transverse fascia and the underlay like a sandwich. The surgical path, method, and patch location of this repair are completely different from those of plain repair. The focus of the operation is to completely cover the pubic muscle hole with a properly sized patch. Kugel reported in 1999 that 808 patients with inguinal hernia were treated with Budd Kugel patch (10cemx8cm) before the peritoneal repair, and only 5 cases had recurrence after surgery, with a recurrence rate of 0.62%. In China, Hong Chu Yuanwen and Zhou Xuelu et al. Used a 12 cmx8 em Kugel oval patch for preperitoneal repair of 158 and 381 cases of inguinal hernia respectively. The long-term follow-up recurrence rates were 0.6% and 0.26%. The above literature confirms the feasibility, safety, and effectiveness of such patches for repairing inguinal hernias, and the results support the research view that a 12 cm x 8 cm size can completely cover the entire pubic muscle foramen. Oversized patches not only increase the difficulty of the operation, but may also cause curling and folding. Too small patches cannot completely cover the pubic muscle holes, which may cause postoperative recurrence.