Otcenasek Michal, Gauruder-Burmester Annett, Haak Lucia A, Grill Robert, Popken Gralf, Baca Vaclav
Department of Urology, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.
Department of Urology and Urogynecology, Klinikum Ernst Von Bergmann, Potsdam, Germany.
Clin Anat. 2016 May;29(4):524-9. doi: 10.1002/ca.22694. Epub 2016 Feb 14.
The lateral support of the vaginal wall depends on the integrity of the paravaginal section of the visceral pelvic fascia, levator ani, and their connection. Various defects of the muscle and fascia can result in identical clinical findings-ie, the descent of the lateral vaginal sulcus. In this study, we created a realistic scheme for classifying paravaginal defects, based on the complex relationship of the pelvic fascia with the levator ani. Surgical observations, cadaver examinations, and a complex magnetic resonance imaging (MRI)-based 3-dimensional (3D) model were used to analyze the spatial relationships of normal and defective anatomy of the female pelvic floor. Descent of the lateral vaginal sulcus can result from a defect in the paravaginal visceral pelvic fascia, levator ani, or both. The fascial defect can be partial or complete, and the muscle defect can vary in location. A detailed illustrated classification is presented. We present a new model of the pathology that underlies a common clinical finding.
阴道壁的侧向支撑取决于盆腔内脏筋膜的阴道旁部分、肛提肌及其连接的完整性。肌肉和筋膜的各种缺陷可导致相同的临床发现，即阴道外侧沟下降。在本研究中，我们基于盆腔筋膜与肛提肌的复杂关系，创建了一种用于阴道旁缺陷分类的切实可行的方案。通过手术观察、尸体检查以及基于磁共振成像（MRI）的复杂三维（3D）模型，来分析女性盆底正常和缺陷解剖结构的空间关系。阴道外侧沟下降可能是由于阴道旁盆腔内脏筋膜、肛提肌或两者的缺陷所致。筋膜缺陷可以是部分或完全的，肌肉缺陷的位置也可能不同。本文给出了详细的图示分类。我们提出了一种导致常见临床发现的病理新模型。
