Important anatomical structures used in paravaginal defect repair: cadaveric study

Ersoy, M. Özcan; Sağsöz, Nevin; Bozkurt, Mehmet; Apaydın, Nihal; Elhan, Alai̇tti̇n; Tekdemi̇r, İbrahi̇m

doi:10.1016/j.ejogrb.2003.06.015

Cited by 13 publications

(22 citation statements)

References 11 publications

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“…Several authors describe the ATFP as a key support structure of the anterior wall [8,18–21,27]. From its origin, 2–3 cm lateral to the pubic bone, the ATFP covers the pubococcygeus and iliococcygeus muscles and stretches toward the ischial spine, where it attaches along with the arcus tendineus levator ani.…”

Section: Anatomymentioning

confidence: 99%

Paravaginal defect: anatomy, clinical findings, and imaging

et al. 2016

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Introduction and Hypothesis The paravaginal defect has been a topic of active discussion concerning 1) what it is; 2) how to diagnose it; 3) its role in anterior vaginal wall prolapse; and 4) if and how to repair it. The aim of this article is to review the existing literature on the paravaginal defect and to discuss its role in the anterior vaginal wall support system, with an emphasis on anatomy and imaging. Methods Articles related to paravaginal defects were identified through a PUBMED search ending July 1, 2015. Results The support of the anterior vaginal wall is a complex system involving the levator ani muscle, the arcus tendineus fascia pelvis (ATFP), the pubocervical fascia, and the uterosacral/cardinal ligaments. Studies conclude that physical examination is inconsistent in detecting paravaginal defects. Ultrasound (US) and magnetic resonance imaging (MRI) have been used to describe patterns in the appearance of the vagina and bladder when a paravaginal defect is suspected. Different terms have been used (e.g. “sagging of bladder base,” “loss of tenting”), which all represent changes in the support of the pelvic floor but which could be due to both paravaginal defects and levator ani defects. Conclusion Paravaginal support plays a role in the support of the anterior vaginal wall, but we still do not know the degree to which it contributes to the development of prolapse. Both MRI and US are useful in the diagnosis of paravaginal defects, but further studies are needed to evaluate their use.

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Section: Anatomymentioning

confidence: 99%

Paravaginal defect: anatomy, clinical findings, and imaging

et al. 2016

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“…16 It is very important that, theoretically, lateral detachment of the cystocele may be aggravated by midline vaginal fascial plication, as in anterior colporrhaphy, and only paravaginal repair can restore the detached cystocele to its original position. 17 Our study showed that the Perigee procedure could restore the advanced cystocele adequately, with points Aa and Ba almost back to natural anatomical positions. Concomitant anti-incontinence surgeries performed with the Perigee procedure may compromise the surgical effectiveness and cause additional complications.…”

Section: Discussionmentioning

confidence: 48%

“…published this review that they attracted great attention because of the difficulties involved when working in deep structures 16 . It is very important that, theoretically, lateral detachment of the cystocele may be aggravated by midline vaginal fascial plication, as in anterior colporrhaphy, and only paravaginal repair can restore the detached cystocele to its original position 17 . Our study showed that the Perigee procedure could restore the advanced cystocele adequately, with points Aa and Ba almost back to natural anatomical positions.…”

Section: Discussionmentioning

confidence: 54%

Prospective assessment of overactive bladder symptoms in women who have undergone transvaginal surgery for advanced vaginal wall prolapse: A preliminary report

Chin

Lin

et al. 2009

J of Obstet and Gynaecol

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“…Some of them consider only variants of the arterial obturator vessels [10][11][12][13][14][15][16][17][18]. Other studies discuss the presence of venous aberrant obturator vessels as well [1,3,4,6,8,9,[19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Aberrant obturator vessels in minimally invasive pelvic lymph node dissection

et al. 2013

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The presence of aberrant obturator vessels, arising from the external iliac circulatory system and their lesion during a surgical intervention in the area, may lead to bleeding, which is difficult to control. For a period of 5 years, 133 endoscopic bilateral pelvic lymph node dissections in patients with cervical cancer were performed, and the present aberrant vessels were registered and filmed. Aberrant obturator vessels were present in 58 cases (43.6 %). Eight obturator arteries and 58 obturator veins, branches of the external iliac vascular system, were visualized. Arterial type of obturator variation was found in one (0.07 %) case, venous type-in 50 (37.5 %), and combined (arterial and venous) type-in seven (5.26 %), out of all patients. Of the observed aberrant obturator arteries, three were found to arise from the inferior epigastric artery, and five from the external iliac artery. Of all available 73 veins, 51 (70 %) drained directly into the external iliac vein and 22 (30 %) in the inferior epigastric vein. The frequency of the aberrant obturator veins was 27.44 % (n =73), and of the arteries-3 %, related to the investigated pelvic halves (n =266). The presence of aberrant obturator vessels is a relatively common anatomic variation, important for the clinical practice.

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Important anatomical structures used in paravaginal defect repair: cadaveric study

Cited by 13 publications

References 11 publications

Paravaginal defect: anatomy, clinical findings, and imaging

Paravaginal defect: anatomy, clinical findings, and imaging

Prospective assessment of overactive bladder symptoms in women who have undergone transvaginal surgery for advanced vaginal wall prolapse: A preliminary report

Aberrant obturator vessels in minimally invasive pelvic lymph node dissection

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