Richardson A C, Lyon J B, Williams N L
Am J Obstet Gynecol. 1976 Nov 1;126(5):568-73. doi: 10.1016/0002-9378(76)90751-1.
The concept is presented that most cystoceles and/or urethroceles result from insolated defects in the connective tissue supports of the anterior quadrant of the pelvis. Four areas in which defects have been found to occur are identified. Sixty patients are presented who were found to have isolated defects in the endopelvic fascia at the lateral sidewall of the pelvis with significant cystourethroceles and stress urinary incontinence. The surgical treatment consisted only of a direct approach to and closure of the isolated defect. The operative results at 3 to 48 months were excellent in 91.7 per cent, improved in 5 per cent, and failed in 3.3 per cent. Discussion is offered of the possibility of the study of the pelvic floor from the viewpoint of a mechanical engineer.
本文提出的概念是，大多数膀胱膨出和/或尿道膨出是由骨盆前象限结缔组织支撑结构的孤立缺陷引起的。确定了已发现缺陷发生的四个区域。报告了60例患者，他们在骨盆侧壁的盆腔内筋膜中存在孤立缺陷，伴有明显的膀胱尿道膨出和压力性尿失禁。手术治疗仅包括直接处理并封闭孤立缺陷。3至48个月的手术结果显示，91.7%的患者效果极佳，5%的患者有所改善，3.3%的患者手术失败。文中还从机械工程师的角度讨论了研究盆底的可能性。
