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Erschienen in: International Urogynecology Journal 5/2017

17.09.2016 | Review Article

Paravaginal defect: anatomy, clinical findings, and imaging

verfasst von: Louise T. S. Arenholt, Bodil Ginnerup Pedersen, Karin Glavind, Marianne Glavind-Kristensen, John O. L. DeLancey

Erschienen in: International Urogynecology Journal | Ausgabe 5/2017

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Abstract

Introduction and hypothesis

The paravaginal defect has been a topic of active discussion concerning what it is, how to diagnose it, its role in anterior vaginal wall prolapse, and if and how to repair it. The aim of this article was to review the existing literature on paravaginal defect and discuss its role in the anterior vaginal wall support system, with an emphasis on anatomy and imaging.

Methods

Articles related to paravaginal defects were identified through a PubMed search ending 1 July 2015.

Results

Support of the anterior vaginal wall is a complex system involving levator ani muscle, arcus tendineus fascia pelvis (ATFP), pubocervical fascia, and uterosacral/cardinal ligaments. Studies conclude that physical examination is inconsistent in detecting paravaginal defects. Ultrasound (US) and magnetic resonance imaging (MRI) have been used to describe patterns in the appearance of the vagina and bladder when a paravaginal defect is suspected. Different terms have been used (e.g., sagging of bladder base, loss of tenting), which all represent changes in pelvic floor support but that could be due to both paravaginal and levator ani defects.

Conclusion

Paravaginal support plays a role in supporting the anterior vaginal wall, but we still do not know the degree to which it contributes to the development of prolapse. Both MRI and US are useful in the diagnosis of paravaginal defects, but further studies are needed to evaluate their use.
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Metadaten
Titel
Paravaginal defect: anatomy, clinical findings, and imaging
verfasst von
Louise T. S. Arenholt
Bodil Ginnerup Pedersen
Karin Glavind
Marianne Glavind-Kristensen
John O. L. DeLancey
Publikationsdatum
17.09.2016
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 5/2017
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-016-3096-3