Document Detail

Rectovaginal fascia: An important structure in pelvic visceral surgery? About its development, structure, and function.
MedLine Citation:
PMID:  11912525     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The existence, development, and function of the rectovaginal fascia has been discussed in literature. In women, a defect in the fascia leads to rectoceles and severe constipation. In pediatric textbooks for anorectal or urogenital surgery, however, it is not mentioned. Does the fascia exist in children? METHODS: The pelvises of 31 female and, as controls, 31 male fetuses (age from 9 weeks of gestation to newborn) were plastinated. Sections (transversal, sagittal, and frontal) were stained with azure II/ methylenblue/ basic fuchsin and viewed at a magnification of 6.5x to 80x. In addition, the authors investigated macroscopically and microscopically the rectovaginal fascia in 1 fetal and 1 adult cadaver. RESULTS: At the beginning of the fetal period the authors recognized the anlage of the rectovaginal fascia caudal from the rectouterine excavation. Later, a fascia of connective tissue develops. It is connected directly to areolar connective tissue at the dorsal wall of the vagina. Neurovascular bundles are situated ventrolaterally of the rectal wall. At the level of the anorectal flexure this fascia separates the rectum and the vagina. CONCLUSIONS: Our investigations indicate that the rectovaginal fascia is completely developed in newborns, through differentiation of mesenchyme, which develops into a fascia. It protects different compartments and serves as an abutment to the rectal wall. Thus, it is important for adequate bowel emptying. For the surgeon it is a leading structure for preventing nerve damage of the autonomic nerve supply of the pelvic organs. It should be known, protected, and, if necessary, reconstructed.
Barbara Ludwikowski; Irene Oesch Hayward; Helga Fritsch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  37     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-03-25     Completed Date:  2002-05-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  634-8     Citation Subset:  IM    
Copyright Information:
Copyright 2002, Elsevier Science (USA). All rights reserved.
St Johanns-Spital Landesklinik für kinderchirurgie, Salzburg, Austria.
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MeSH Terms
Embryonic and Fetal Development
Fascia / anatomy & histology,  embryology*,  growth & development,  surgery
Fetus / anatomy & histology
Gestational Age
Infant, Newborn
Rectum / anatomy & histology,  embryology*,  growth & development
Vagina / anatomy & histology,  embryology*,  growth & development

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