382 Obstetrics and Gynecology Board Review •••
❍ The Moschcowitz or Halban techniques although different are used to accomplish what?
Cul-de-sac obliteration to prevent enterocele.
❍ To what structure is the distal posterior wall of the vaginal fused?
Perineal body.
❍ What procedure done at time of posterior compartment repair can cause dyspareunia?
Levator Ani plication.
❍ Name two defects resulting from anterior vaginal prolapse.
Cystocele and cystourethrocele.
❍ Patient with symptoms of pelvic organ prolapse should be evaluated in what positions?
Sitting, standing, and lithotomy.
❍ Name three urologic complications of anterior colporrhaphy.
Incontinence, ureteral injury, cystotomy, vesicovaginal fistula, and urethral injury.
❍ Wide sheets of anterior and posterior vaginal epithelium are removed and the denuded walls are then
approximated in what procedure?
Le Fort.
❍ What is the common name of the arcus tendineus fascia pelvis?
White line.
❍ What are the three goals in the management, whether operative or nonoperative, of genital prolapse?
Relief of symptoms, restoration of anatomy, and preservation or restoration of normal function.
❍ What is the most common defect in cystocele?
Paravaginal defect.
❍ Describe supporting system of vagina.
Apex of the vagina is suspended with cardinal-uterosacral ligament complex, majority of mid vagina is attached
with white line of fascia pelvic up to the level of ischial spine, and base of the vagina is fused with perineal body
and pubic bone.
❍ Name the muscle groups of the pelvis.
Iliopsoas, obturator internus, piriformis, ischicoccygeal, iliococcygeal, puborectalis, coccygeus, and urogenital
diaphragm.
❍ What is the specific defect seen in prolapse of the vaginal vault after hysterectomy?
Failure of vaginal cuff suspension with cardinal-uterosacral ligament complex.