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Medial cystocele forms in the mid-vagina and is related to a defect in the suspension provided by to a sagittal suspension system defect in the uterosacral ligaments and pubocervical fascia. The pubocervical fascia may thin or tear and create the cystocele. An aid in diagnosis is the creation of a 'shiny' spot on the epithelium of the vagina.
[2] [10] Forms of colpopexy include sacrocolpopexy, in which the vaginal vault is attached to the sacrum using a surgical mesh; sacrospinous ligament fixation, in which the upper vagina is attached to the sacrospinous ligaments using sutures; and uterosacral ligament vaginal vault suspension, in which the upper vagina is attached to the ...
The uterosacral ligaments (or rectouterine ligaments [1]) are major ligaments of uterus that extend posterior-ward from the cervix to attach onto the (anterior aspect of the [2]) sacrum. [ 3 ] Structure
The vaginal support structures are those muscles, bones, ligaments, tendons, membranes and fascia, of the pelvic floor that maintain the position of the vagina within the pelvic cavity and allow the normal functioning of the vagina and other reproductive structures in the female.
The vaginal cuff is created by suturing together the edges of the surgical site where the cervix was attached to the vagina. This is accomplished by bringing the edges of the vagina together and suturing them together and to the uterosacral ligaments to prevent prolapse. The peritoneum is also sewn into the newly created vaginal cuff. [1]
The rectouterine pouch, being the lowest part of the peritoneal cavity in a woman at supine position, is a common site for the spread of pathology such as ascites, tumour, endometriosis, pus, etc. As it is the furthest point of the abdominopelvic cavity in women, it is a site where infection and fluids typically collect.
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Colposacropexy is often used for treating vaginal vault prolapse. A Cochrane Collaboration review [ needs update ] found that limited data are available on optimal surgical approaches, including the use of transvaginal surgical mesh devices, in the form of a patch or sling , similar to its implementation for abdominal hernia .