The structures involved in the repair of a defective perineum are muscles and fasciæ. The operative procedure consists in denudation with coaptation or flapsplitting methods. Notwithstanding the successful claims in the varied surgical methods of colpoperineorrhaphy the anatomical basis is neither generally nor perfectly understood. It is probable, however, that the essential success lies in the reunion of the separated levator ani muscle by means of its fasciæ superior and inferior with some other fasciæ, and also that this success has been chiefly due to deep suturing. The object of this essay is to demonstrate that the chief factor in successful colpoperineorrhaphy is the restoration by the aid of deep sutures of the fasciæ, especially the levator ani fasciæ, superior and inferior.
The muscles of the pelvic floor may be divided into two classes: a, the deep layer—the levator ani coccygeus and pyriformis; b, the superficial layer—the transverse perinei, bulbo-cavernosus