Related Experiment Video
Updated: Aug 6, 2025
07:41
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
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Apical defect - the essence of cystocele pathogenesis?
Pawel Szymanowski1, Wioletta K Szepieniec1, Hanna Szweda2
1Department of Gynecology and Obstetrics, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, Cracow, Poland, Poland.
Ginekologia Polska
|March 17, 2023
Summary
An apical defect significantly contributes to cystocele formation in women, often exclusively or alongside other anterior compartment defects. Understanding this apical defect is crucial for effective cystocele treatment planning.
Area of Science:
- Urogynecology
- Pelvic Floor Disorders
- Female Pelvic Medicine
Background:
- Standardization in cystocele treatment planning and surgical evaluation is lacking.
- Current systems like POP-Q and DeLancey's levels do not fully address cystocele caused by apical defects.
Purpose of the Study:
- To evaluate the impact of apical (Level I) defects on cystocele development.
- To assess the role of apical defects in the pathogenesis of anterior compartment prolapse.
Main Methods:
- A urogynecological examination was performed on women with cystocele complaints.
- A standardized method, expanding the POP-Q System and DeLancey's levels, was used.
- The study specifically evaluated the influence of Level I defects on Level II prolapse.
Main Results:
- Apical defects contributed to cystocele in 72.2% of 302 patients.
- Cystocele was exclusively caused by an apical defect in 30.8% of cases.
- Concomitant apical and Level II defects caused cystocele in 41.4% of patients.
Conclusions:
- Apical defects play a significant role in cystocele development.
- Considering apical defects is essential for effective surgical planning in cystocele treatment.
- Failure to account for apical defects may lead to ineffective cystocele treatments.
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