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- W2488375215 abstract "The support of the anterior vaginal wall, with its overlying bladder and urethra, is dependentupon the inherent strength of the pubocervical fascia and its lateral attachment to the pelvicsidewalls. Specifically, the pubocervical fascia is attached to the arcus tendineus fascia pelvis(also termed “the white line”). The arcus tendineus fascia pelvis is a condensation of interveningconnective tissue overlying the obturator internus muscle (Fig. 1). Upon vaginal inspection theanterior lateral vaginal sulcus shows excellent support when the pubocervical fascia and thearcus tendineus are intact (Fig. 2). Loss of the lateral vaginal attachment to the pelvic sidewallis called a paravaginal defect and usually results in a cystourethrocele, urethral hypermobility,and/or stress urinary incontinence (Fig. 3). Vaginal inspection in patients with bilateral paravaginal defects reveals loss of anterior vaginal wall support with detachment of thelateral sulci, resulting in a displacement cystocele (Fig. 4). White (1) first described the para-vaginal repair in 1909, but it did not gain popularity until decades later, when Richardson(2,3) and Shull (4,5) described their abdominal and vaginal approaches to this type of anteriorwall repair. Paravaginal defect repair has been described using not only vaginal and openabdominal approaches but also, more recently, via a laparoscopic approach (6-8)." @default.
- W2488375215 created "2016-08-23" @default.
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- W2488375215 date "2004-12-29" @default.
- W2488375215 modified "2023-09-25" @default.
- W2488375215 title "Surgical Treatment of Vaginal Apex Prolapse" @default.
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- W2488375215 doi "https://doi.org/10.1201/b14154-48" @default.
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