Pelvic relaxation involving the middle compartment.
Loss of pelvic support involving the 'middle compartment' is manifested by herniation through the central pelvic floor in proximity to the intersection of an imaginary line from the public symphysis to the coccyx with another from one ischial spine to opposite ischial spine. Loss of middle compartment support may exist in association with 'anterior compartment' defects, 'posterior compartment' defects, or both. The severity of middle compartment relaxation ranges from mild uterine descensus to total uterovaginal prolapse when the uterus is present. When the uterus has been removed, it may range from vaginal vault descent to total vaginal eversion and includes all grades of enterocele. Middle compartment defects are usually not isolated. The recent literature relevant to middle compartment defects consists primarily of additional reports on surgical management, including continued modification and evolution of surgical techniques. Larger surgical series with longer follow-up periods have been reported. Cadaveric and histologic studies have appeared which have added to the understanding of normal anatomy and the disruptions thereof, which can cause middle compartment defects. Sophisticated diagnostic imaging techniques have generated preliminary reports which are of interest.
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
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MC
Timmons
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Addison
D005260:Female; D006801:Humans; D008722:Methods; D009126:Muscle Relaxation; D017773:Pelvic Floor / Q000503:physiopathology* / Q000601:surgery; D014596:Uterine Prolapse / Q000503:physiopathology / Q000601:surgery