Surgical anatomy of the mid‐vagina

Haylen, Bernard T.; Vu, Dzung; Wong, Audris; Livingstone, Sarah

doi:10.1002/nau.24994

Cited by 5 publications

(2 citation statements)

References 37 publications

(141 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is because the vagina of cis-females has three layers anatomically. They are the mucosal layer, the muscular layer containing two layers of circular smooth muscles, and the serosa layer [ 19 ]. All these layers are absent in the study group as the latter has only penile skin in the neovagina.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of Magnetic Resonance Imaging for Feminizing Gender Affirmation Genital Surgery: A Novel Approach

Vaithiya,

Subbaraj

2024

Cureus

View full text Add to dashboard Cite

Background Gender dysphoria is treated with gender affirmation surgery (GAS) for assigned male at birth (AMAB) individuals. This study aimed to evaluate the postoperative anatomical changes in AMAB individuals who underwent GAS using magnetic resonance imaging (MRI) and to compare it with cis-females, thereby assessing the efficacy of the surgical technique in achieving pelvic anatomy similar to cis-females. Methodology This was a prospective observational study done in a tertiary care hospital. AMAB individuals who underwent gender affirmation genital surgery using single-stage solely penile skin inversion vaginoplasty were included after informed consent and approval by the Institutional Human Ethics Committee. Patients with complications such as deep space surgical site infection (SSI) and neo-vaginal prolapse were excluded. All the study participants were advised a vaginal self-dilatation regimen, reviewed three months after the surgery, and subjected to an MRI of the pelvis with a vaginal tutor. Parameters such as neo-vaginal depth, alpha (α) angle, rectovaginal thickness, and remnant of corpora cavernosa were measured and compared with cis-female parameters measured from images in the archives from the Department of Radiology. Result A total of 21 patients were included in the study, with a mean age of 27±4.7. Between the study group and cis-females, no significant difference was seen in vaginal depth, and cis-females had significantly higher values in other parameters. There was a significant difference between the subgroups, i.e., defaulters and non-defaulters in soft tissue parameters such as vaginal depth (p=0.001), α angle (p=0.002), and rectovaginal thickness (p=0.002) with the non-defaulter patients having higher values. Conclusion Single-stage penile skin inversion vaginoplasty is capable of producing anatomical parameters, importantly neo-vaginal depth, which is fairly comparable with cis-female, as evident in the non-defaulter subgroup patients. Proper compliance with the vaginal dilatation regimen plays a significant role in the maintenance of soft tissue pelvic anatomical parameters.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of Magnetic Resonance Imaging for Feminizing Gender Affirmation Genital Surgery: A Novel Approach

Vaithiya,

Subbaraj

2024

Cureus

View full text Add to dashboard Cite

show abstract

“…The adventitia layer is rich in elastic fibers, providing excellent elasticity to the vaginal canal. In addition, the adventitia layer contains veins, arteries, and nerves [52][53][54].…”

Section: Brief Histology Of Vagina and Biology Of Ecmmentioning

confidence: 99%

Extracellular Matrix-Based and Electrospun Scaffolding Systems for Vaginal Reconstruction

et al. 2023

View full text Add to dashboard Cite

Congenital vaginal anomalies and pelvic organ prolapse affect different age groups of women and both have significant negative impacts on patients’ psychological well-being and quality of life. While surgical and non-surgical treatments are available for vaginal defects, their efficacy is limited, and they often result in long-term complications. Therefore, alternative treatment options are urgently needed. Fortunately, tissue-engineered scaffolds are promising new treatment modalities that provide an extracellular matrix (ECM)-like environment for vaginal cells to adhere, secrete ECM, and be remodeled by host cells. To this end, ECM-based scaffolds or the constructs that resemble ECM, generated by self-assembly, decellularization, or electrospinning techniques, have gained attention from both clinicians and researchers. These biomimetic scaffolds are highly similar to the native vaginal ECM and have great potential for clinical translation. This review article aims to discuss recent applications, challenges, and future perspectives of these scaffolds in vaginal reconstruction or repair strategies.

show abstract

Surgical anatomy of the mid‐vagina

Haylen

Wong

et al. 2022

Neurourology and Urodynamics

Self Cite

View full text Add to dashboard Cite

Aim The mid‐vagina (MV) represents Level II of the vagina. The surgical anatomy of the MV has not been recently subject to a comprehensive examination and description. MV surgery involving anterior and posterior colporrhaphy represents a key part of surgery for a majority of pelvic organ prolapse (POP). Methods Literature review and surgical observations of many aspects of the MV were performed including MV length and width; MV shape; immediate relationships; histological analysis; anterior and posterior MV prolapse assessment and anterior MV surgical aspects. Unpublished pre‐ and postoperative quantitative data on 300 women undergoing posterior vaginal compartment repairs are presented. Results The MV runs from the lower limit of the vaginal vault (VV) to the hymen. Its length is a mean of 5 cm. Its shape in section overall is a compressed rectangle. Its longitudinal shape is created by its anterior and posterior walls being inverse trapezoid in shape. Histology comprises three layers: (i) mucosa; (ii) muscularis; (iii) adventitia. MV prolapse staging uses pelvic organ prolapse quantification (POP‐Q). Anterior MV prolapse can be quantitatively assessed using POP‐Q while posterior MV prolapse can be assessed with POP‐Q or PR‐Q. Around 50% of both cystocele and rectocele are due to VV defects. POP will increase anterior MV width and length. Native tissue anterior colporrhaphy is the current conventional repair with mesh disadvantages outweighing advantages. Posteriorly, Level II (MV) defects are far smaller (mean 1.3 cm) than Level I (mean 6.0 cm) and Level III (mean 2.9 cm). Conclusion An understanding of the surgical anatomy of the MV can assist anterior and posterior colporrhaphy. In particular, if VV support is employed, the Level II component of a posterior repair should be relatively small.

show abstract

Surgical anatomy of the mid‐vagina

Cited by 5 publications

References 37 publications

Evaluation of the Efficacy of Magnetic Resonance Imaging for Feminizing Gender Affirmation Genital Surgery: A Novel Approach

Evaluation of the Efficacy of Magnetic Resonance Imaging for Feminizing Gender Affirmation Genital Surgery: A Novel Approach

Extracellular Matrix-Based and Electrospun Scaffolding Systems for Vaginal Reconstruction

Surgical anatomy of the mid‐vagina

Contact Info

Product

Resources

About