TY - JOUR
T1 - Anatomic relationship between the vaginal apex and the bony architecture of the pelvis
T2 - A magnetic resonance imaging evaluation
AU - Gutman, Robert E.
AU - Pannu, Harpreet K.
AU - Cundiff, Geoffrey W.
AU - Melick, Clifford F.
AU - Siddique, Sohail A.
AU - Handa, Victoria L.
PY - 2005/5
Y1 - 2005/5
N2 - Objective: This study was undertaken to define anatomic relationships between the vaginal apex and the ischial spines and sacrum for nulliparous women with normal support. Study design: We retrospectively evaluated the magnetic resonance images of 11 consecutive women who underwent pelvic imaging at Johns Hopkins. Coordinates were recorded for the posterior fornix, sacrum, ischial spines, and cervical vaginal junctions. We calculated vector distances with means, SDs, and 95% CIs. Intraclass correlation coefficients tested interobserver reliability and the Wilcoxon signed rank test compared right- and left-sided measurements. Results: Mean age was 30.4 ± 9.1 years. The cervical vaginal junction was 1.6 ± 0.5 cm superior, 1.1 ± 0.5 cm anterior, and 4.7 ± 0.4 cm medial to the ipsilateral ischial spine. The posterior fornix was 1.0 ± 1.0 cm anterior and 5.3 ± 0.8 cm inferior to the second sacral vertebra. There was excellent interobserver reliability (interclass correlation coefficients = 0.997, P < .001) and no detectable difference between sides. Conclusion: Consistent relationships exist betweem the vaginal apex and ischial spines and sacrum, which may be useful in reconstructive pelvic surgery.
AB - Objective: This study was undertaken to define anatomic relationships between the vaginal apex and the ischial spines and sacrum for nulliparous women with normal support. Study design: We retrospectively evaluated the magnetic resonance images of 11 consecutive women who underwent pelvic imaging at Johns Hopkins. Coordinates were recorded for the posterior fornix, sacrum, ischial spines, and cervical vaginal junctions. We calculated vector distances with means, SDs, and 95% CIs. Intraclass correlation coefficients tested interobserver reliability and the Wilcoxon signed rank test compared right- and left-sided measurements. Results: Mean age was 30.4 ± 9.1 years. The cervical vaginal junction was 1.6 ± 0.5 cm superior, 1.1 ± 0.5 cm anterior, and 4.7 ± 0.4 cm medial to the ipsilateral ischial spine. The posterior fornix was 1.0 ± 1.0 cm anterior and 5.3 ± 0.8 cm inferior to the second sacral vertebra. There was excellent interobserver reliability (interclass correlation coefficients = 0.997, P < .001) and no detectable difference between sides. Conclusion: Consistent relationships exist betweem the vaginal apex and ischial spines and sacrum, which may be useful in reconstructive pelvic surgery.
KW - Ischial spines
KW - Magnetic resonance imaging
KW - Vaginal apex
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U2 - 10.1016/j.ajog.2004.11.028
DO - 10.1016/j.ajog.2004.11.028
M3 - Article
C2 - 15902155
AN - SCOPUS:20644448831
VL - 192
SP - 1544
EP - 1548
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 5 SPEC. ISS.
ER -