levator ani

I had never seen anything like this before, nor had any other experienced urologist who I showed it to.

Without Herb's contribution of harvesting the adult prostate, which revealed the levator fascia, it would have been impossible to formulate the precise steps in creating the operative technique.

At that time, no one recognized the existence of the levator fascia, and it took many months for me to understand it.

So what was the breakthrough that happened that made you understand it?

Well, that was during my Christmas vacation that year, when I had time to give this serious thought.

My former chief at UCLA, Will Goodwin, had given me the two-volume Young and Davis textbook of urology from 1926, and I found the answer in there.

Everyone knew about Denonvier's fascia and the prostatic capsule, but not the levator or lateral pelvic fascia.

Outside the prostatic capsule, there is another layer of fascia that lines the levator muscles, the levator fascia.

I'm going to get a little technical.

Would you say the perineum muscles are more oriented toward sexual function, the levator more sort of that… structural hammock? Is that sort of the organization of this?

Layer three, the deeper layer of the pelvic floor is more meant for pulling up and in on those pelvic organs.

So layer three is what? Are you going to make me name the muscles? No, you don't need to.

The pubococcygeus, the iliococcygeus and the coccygeus.

Right, which are the levator muscles.

Yes.

The levator and eye muscles, yeah.