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Ischiocavernosus muscle (Female)

The ischiocavernosus muscle is a paired perineal muscle in females that plays an important role in sexual function. It lies in the superficial perineal pouch and covers the crus of the clitoris. Contraction of this muscle compresses the crura, restricting venous outflow and thereby assisting in clitoral erection. It is clinically relevant in pelvic floor anatomy, urogynecology, and radiologic imaging of the perineum.

Synonyms

  • Crus compressor muscle of clitoris

  • Ischiocavernosus of the superficial perineal pouch

Origin, Course, and Insertion

  • Origin: Arises from the inner surface of the ischial tuberosity and the ischiopubic ramus

  • Course: Fibers run forward and medially, covering the crus of the clitoris along its course

  • Insertion: Fibers insert into the fascia surrounding the crus of the clitoris and merge anteriorly with fibers of the contralateral ischiocavernosus

Relations

  • Anteriorly: Crus of the clitoris and body of clitoris

  • Posteriorly: Superficial transverse perineal muscle

  • Superiorly: Perineal membrane

  • Inferiorly: Subcutaneous perineal tissue and skin

Function

  • Compresses the crus of the clitoris, restricting venous drainage

  • Assists in maintaining clitoral erection during sexual arousal

  • Contributes to tightening of the vaginal introitus

  • Provides structural support to the superficial perineal pouch

Clinical Significance

  • Important in female sexual function and pelvic floor stability

  • May be involved in perineal trauma during childbirth

  • Relevant in pelvic floor reconstructive surgery

  • Visible on imaging, and should not be confused with pathology in the perineal region

  • Weakness or damage can contribute to pelvic floor dysfunction

MRI Appearance

T1-weighted images:

  • Appears as a thin, low-signal band covering the crus of the clitoris

  • Surrounded by bright fat signal in the superficial perineum

T2-weighted images:

  • Low signal intensity relative to surrounding bright perineal fat

  • May appear slightly more conspicuous if adjacent to high-signal edema or fluid

STIR (Short Tau Inversion Recovery):

  • Normal muscle remains dark

  • Pathology such as edema, inflammation, or trauma appears bright

T1 Fat-Sat Post-Contrast:

  • Normal muscle shows mild, uniform enhancement

  • Pathology (inflammation, trauma, tumor infiltration) may show focal or heterogeneous enhancement

CT Appearance

Non-Contrast CT:

  • Appears as a thin, soft tissue density band along the ischiopubic ramus covering the crus of clitoris

  • Usually indistinct unless outlined by surrounding fat or fluid

Post-Contrast CT:

  • Enhances mildly and uniformly under normal conditions

  • Pathology such as inflammation, infection, or tumor infiltration appears as focal or irregular enhancement

MRI image

Ischiocavernosus muscle female MRI axial anatomy image-img-00000-00000_00001

MRI image

Ischiocavernosus muscle female MRI sag anatomy image-img-00000-00000

CT image

Ischiocavernosus muscle female CT axial anatomy image-img-00000-00000