ArticleInternational urogynecology journal2014
The length of anterior vaginal wall exposed to external pressure on maximal straining MRI: relationship to urogenital hiatus diameter, and apical and bladder location.
Article in International urogynecology journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Pelvic inclination correction system for magnetic resonance imaging analysis of pelvic organ prolapse in upright position.International urogynecology journal · 2022Article
- Comparison of the Axes and Positions of the Uterus and Vagina Between Women With and Without Pelvic Floor Organ Prolapse.Frontiers in surgery · 2022Article
- Defining mechanisms of recurrence following apical prolapse repair based on imaging criteria.American journal of obstetrics and gynecology · 2021Article
- Association between overactive bladder and pelvic organ mobility as evaluated by dynamic magnetic resonance imaging.Scientific reports · 2021Article
- Appearance of the levator ani muscle subdivisions on 3D transperineal ultrasound.Insights into imaging · 2021Article
- Associating genital hiatus size with long-term outcomes after apical suspension.International urogynecology journal · 2020Article
- From molecular to macro: the key role of the apical ligaments in uterovaginal support.American journal of obstetrics and gynecology · 2020Review
- Comparison of measurement systems for posterior vaginal wall prolapse on magnetic resonance imaging.International urogynecology journal · 2019Article
- Natural history of pelvic organ prolapse in symptomatic patients actively seeking treatment.International urogynecology journal · 2018Article
- Intraoperative cervix location and apical support stiffness in women with and without pelvic organ prolapse.American journal of obstetrics and gynecology · 2017Observational
- A retrospective comparison of two vaginal mesh kits in the management of anterior and apical vaginal prolapse: long-term results for apical fixation and quality of life.International urogynecology journal · 2016Article
- What's new in the functional anatomy of pelvic organ prolapse?Current opinion in obstetrics & gynecology · 2016Review
- Cystocele and functional anatomy of the pelvic floor: review and update of the various theories.International urogynecology journal · 2016Review
- The long and short of it: anterior vaginal wall length before and after anterior repair.International urogynecology journal · 2015Article
- Effect of Cystocele Repair on Cervix Location in Women With Uterus In Situ.Female pelvic medicine & reconstructive surgeryArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
introduction and hypothesisIn cystoceles, the distal anterior vaginal wall (AVW) bulges out through the introitus and is no longer in contact with the posterior vaginal wall or perineal body, exposing the pressure differential between intra-abdominal pressure and atmospheric pressure. The goal of this study is to quantify the length of the exposed vaginal wall length and to investigate its relationship with other factors associated with the AVW support, such as most dependent bladder location, apical location, and hiatus diameter, demonstrating its key role in cystocele formation.
methodsFifty women were selected to represent a full spectrum of AVW support. Each underwent supine, dynamic MR imaging. Most dependent bladder location and apical location were measured relative to the average normal position on the mid-sagittal plane using the Pelvic Inclination Correction System . The length of the exposed AVW and the hiatus diameter were measured as well. The relationship between exposed AVW and most dependent bladder location, apical location, and hiatus diameter were examined.
resultsA bilinear relationship has been observed between exposed vaginal wall length and most dependent bladder location (R(2) = 0.91, P < 0.001). When the bladder descents up to the inflection point (about 4.4 cm away from its normal position), there is little change in the exposed AVW length. With further descent, the exposed vaginal wall length increases significantly, with a 2 cm increase in exposed AVW length for every additional 1 cm of drop bladder location. A similar but weaker bilinear relationship exists between exposed AVW and apical location. Exposed vaginal wall length is also highly correlated with hiatus diameter (R(2) = 0.85, P < 0.001).
conclusionA bilinear relationship exists between exposed vaginal wall length and most dependent bladder location and apical location. It is when the bladder descent is beyond the inflection point that exposed vaginal wall length increases significantly.
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