Vaginal Prolapse Relaxation - Images - Cystocele
|
|
|
Cystourethrocele - is a combined "cystocele" and "urethrocele" in other words there is a loss of support for the whole anterior vaginal wall. The main supportive layer known as the pubocervical fascia is no longer supporting the bladder or urethra appropriately. |
Cystourethrocele - as seen on vagina inspection |
|
Vaginal and Uterine Support (side view) - Note the upper pubocervical fascia supports the bladder and urethra, the lower rectovaginal fascia supports the rectum. Specifically the rectovaginal fascia keeps the rectum from protruding into the vagina. Both of the pubocervical and rectovaginal fascia attach to the uterus which in turn attaches to the uterosacral ligaments. There is a continuous supportive structure (fascia) from the opening of the vagina to the uterosacral ligaments. |
Anterior Vagina Normal Support - (aerial view) The bladder and urethra sit on the pubocervical fascia. The pubocervical fascia is attached laterally to the arcus tendineus on both sides. |
|
|
|
|
Cystocele midline or central defect - (side view) - This patient has a cystocele due to a midline or central defect on the pubocervical fascia (support system). Now the bladder is sagging in the area lacking fascia. To repair this area an anterior repair should be performed to specifically correct the pubocervical fascia defect. |
Cystocele (Midline Defect) - Vaginal View - here the skin has been pulled back to demonstrate the hole or defect in the pubocervical fascia (supportive layer). The defect in the supportive layer allows the bladder to come in direct contact with the vaginal skin resulting in a cystocele. |
|
Normal Anterior Vaginal Wall - (aerial view) |
Paravaginal (lateral) defect - resulting in a cystocele (aerial view) |
