“…Stephens (1986) [14] laid maximum stress that the puborectalis sling is responsible for maintaining continence. Both Stephens and Rehbein did not give enough consideration to the external sphincter component, which was deliberately preserved by Yokoyama et al (1985) [15], in addition to using fibers of the internal sphincter. Pena (1985) [6] changed the concept of perineal musculature and postulated that instead of different muscle slings (ie, puborectalis), the perineal muscles were continuous, and the levators were joined to the external sphincter fibers with the help of the striated muscle complex.…”