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01.03.2014 | Original Article

The rectovaginal septum: visible on magnetic resonance images of women with Mayer-Rokitansky-Küster-Hauser syndrome (Müllerian agenesis)

verfasst von: Markus Huebner, Katharina Rall, Sara Yvonne Brucker, Christl Reisenauer, Katja Claudia Siegmann-Luz, John O. L. DeLancey

Erschienen in: International Urogynecology Journal | Ausgabe 3/2014

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Abstract

Introduction and hypothesis

Ongoing debate exists about whether the rectovaginal septum (Denonvilliers’ fascia) is myth or reality. This study evaluates magnetic resonance images (MRI) of women with Müllerian agenesis for the presence of fascial layers between the rectum and the bladder to test the hypothesis that this layer exists in the absence of the vagina.

Methods

This is a secondary analysis of a study describing MRI aspects in women with vaginal agenesis before and after laparoscopic Vecchietti procedure. Study participants (n = 16) had a multiplanar pelvic MR scan. Images were evaluated independently by two investigators (MH, JOLD) for the appearance of layers separate from the bladder and rectum in the area of interest, with characteristic anatomical features of the septum.

Results

Participants’ mean age was 19.4 ± 2.6 years ± standard deviation (SD). In 12 of 16 patients (75 %) a distinct layer between rectum and bladder was identified in either the axial (4/16; 25 %) or sagittal (12/16; 75 %) scan or both. Characteristic anatomical features included lateral attachment to the levator ani muscle, cranial fusion to the cul-de-sac peritoneum, and caudal insertion into the perineal body.

Conclusions

Three quarters of women with Müllerian agenesis have a visible layer between bladder and rectum. As none of the participants had a vagina, these results support the existence of a rectovaginal septum, separate from a vaginal adventitia.

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Titel: The rectovaginal septum: visible on magnetic resonance images of women with Mayer-Rokitansky-Küster-Hauser syndrome (Müllerian agenesis)
verfasst von: Markus Huebner
Katharina Rall
Sara Yvonne Brucker
Christl Reisenauer
Katja Claudia Siegmann-Luz
John O. L. DeLancey
Publikationsdatum: 01.03.2014
Verlag: Springer London
Erschienen in: International Urogynecology Journal / Ausgabe 3/2014
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-013-2214-8

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The rectovaginal septum: visible on magnetic resonance images of women with Mayer-Rokitansky-Küster-Hauser syndrome (Müllerian agenesis)