Review article
https://doi.org/10.26332/kjahae67
Anatomical Basis of Pelvic Floor Defects
Branimir Kelović
; Faculty of Medicine, University of Zagreb, Zagreb, Croatia
Borna Kelović
; Faculty of Medicine, University of Zagreb, Zagreb, Croatia
Vesna Lesko Kelović
; University Hospital Centre Zagreb, Zagreb, Croatia
Ivana Maurac Pašalić
; University Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, Zagreb, Croatia
Mato Pavić
; University Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, Zagreb, Croatia
Abstract
Pelvic Floor Disorders (PFDs) are a common problem affecting women of various ages. Pelvic floor defects are one of the entities that belong to pelvic floor disorders. Each pelvic floor defect is caused by specific damage to the anatomical and functional integrity of the pelvic floor. Understanding the underlying pathological anatomy is crucial for the proper therapeutic approach in treating this condition. Pelvic organ prolapse refers to the descent of pelvic organs into or through the vaginal canal. This includes the bladder, uterus, vaginal vault, small intestine, and large intestine. There are three groups of prolapse: anterior, posterior, and apical. Prolapses occur due to damage to the fibromuscular support system known as the endopelvic fascia, which maintains the pelvic organs in their normal position. To understand the normal statics of pelvic organs, the concept of DeLancey’s levels of support—comprising three levels—is essential. The first level of support consists of the cardinal and uterosacral ligaments. The second level of support consists of the pubocervical and rectovaginal fascia. The third level of support consists of the connection of the vagina to surrounding structures. Each prolapse occurs due to damage to individual levels of support. Thus, defects of the endopelvic fascia have been recognized as key in the pathophysiology of pelvic organ prolapse. Pelvic floor defects often impair the normal mechanisms of maintaining continence, resulting in urinary incontinence as a common symptom of this condition. Only by repairing such damage and restoring the original anatomical relationships can success in surgical therapy be achieved. The aim of this paper is to describe in detail the anatomy of each defect with the purpose of creating a foundation for diagnostic and therapeutic approaches.
Keywords
pelvic organ prolapse, pelvic floor, pelvic floor disorders
Hrčak ID:
342729
URI
Publication date:
29.12.2025.
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