![]() Dynamic MRI studies have revealed that anterior compartment prolapse is also highly correlated (r=0.73) with loss of apical support ( Summers et al., 2006) and vaginal length ( Hsu et al., 2008).Įach of these observations concerns a particular aspect of anterior vaginal wall support and failure. The anterior vaginal wall is supported at its apex by the cardinal and uterosacral ligaments which connect the uterus and cervix to the posterior boney pelvis ( DeLancey 1992). Subsequent investigations have revealed levator ani muscle damage in women with anterior vaginal wall prolapse specifically ( DeLancey et al., 2002) and prolapse in general ( Tunn et al., 1998, Singh et al., 2003, Hoyte et al., 2001 & 2004, DeLancey et al., 2002). ![]() Early studies were focused primarily on the anatomy and failure of ‘paravaginal support’, defined as the connective tissue attaching the mid-portion of the vagina laterally to the pelvic sidewalls ( Richardson, 1976, DeLancey et al., 1992, 2002). ![]() ![]() It is also the site with the highest rate of persistent and recurrent support defects ( Shull et al., 2000).Ī growing number of studies have sought to improve our understanding of normal anterior vaginal support mechanisms as well as how these supports ordinarily prevent cystocele. The anterior vaginal wall prolapse, clinically known as cystocele, is the most common form of pelvic organ prolapse ( Hendrix et al., 2002). ![]()
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