{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:51:17Z","timestamp":1791377477315,"version":"4.3.2"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP19K23821"],"award-info":[{"award-number":["JP19K23821"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP21H03799"],"award-info":[{"award-number":["JP21H03799"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP21K15329"],"award-info":[{"award-number":["JP21K15329"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Anatomy"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study presents a comprehensive investigation of the anatomical features of the levator ani muscle. The levator ani is a critical component of the pelvic floor; however, its intricate anatomy and functionality are poorly understood. Understanding the precise anatomy of the levator ani is crucial for the accurate diagnosis and effective treatment of pelvic floor disorders. Previous studies have been limited by the lack of comprehensive three\u2010dimensional analyses; to overcome this limitation, we analysed the levator ani muscle using a novel 3D digitised muscle\u2010mapping approach based on layer\u2010by\u2010layer dissection. From this examination, we determined that the levator ani consists of overlapping muscle bundles with varying orientations, particularly in the anteroinferior portion. Our findings revealed distinct muscle bundles directly attached to the rectum (LA\u2010re) and twisted muscle slings surrounding the anterior (LA\u2010a) and posterior (LA\u2010p) aspects of the rectum, which are considered functional parts of the levator ani. These results suggest that these specific muscle bundles of the levator ani are primarily responsible for functional performance. The levator ani plays a crucial role in rectal elevation, lifting the centre of the perineum and narrowing the levator hiatus. The comprehensive anatomical information provided by our study will enhance diagnosis accuracy and facilitate the development of targeted treatment strategies for pelvic floor disorders in clinical practice.<\/jats:p>","DOI":"10.1111\/joa.13968","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T01:35:32Z","timestamp":1698370532000},"page":"486-496","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Twisted orientation of the muscle bundles in the levator ani functional parts in women: Implications for pelvic floor support mechanism"],"prefix":"10.1111","volume":"244","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4709-6359","authenticated-orcid":false,"given":"Satoru","family":"Muro","sequence":"first","affiliation":[{"name":"Department of Clinical Anatomy Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoko","family":"Moue","sequence":"additional","affiliation":[{"name":"Department of Clinical Anatomy Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2927-2937","authenticated-orcid":false,"given":"Keiichi","family":"Akita","sequence":"additional","affiliation":[{"name":"Department of Clinical Anatomy Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,26]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"571","article-title":"The anterior fibres of the levator ani muscle in man","volume":"128","author":"Ayoub S.F.","year":"1979","journal-title":"Journal of Anatomy"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12565-019-00492-4"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2395-9"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200434070-00004"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000002526"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2889-0"},{"key":"e_1_2_12_8_1","first-page":"129","volume-title":"Eurographics Italian chapter conference, Salerno, Italy","author":"Cignoni P.","year":"2008"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(50)90208-X"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-022-05087-8"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200301000-00012"},{"key":"e_1_2_12_12_1","first-page":"765","article-title":"Histology of the connection between the vagina and levator ani muscles. 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