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Gynecological influencing factors on the rectovaginal septum’s morphology

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Abstract

Introduction and hypothesis

The objective was to determine the mean morphometric characteristics of the rectovaginal septum (RVS) and its variations in correlation with the number of pregnancies, method of delivery, parity, and estrogenic exposure.

Methods

An observational, cross-sectional, retrospective, descriptive, and comparative study was carried out. Pelvic MRI of Hispanic women (≥15 years of age) from the northeast of Mexico were obtained. Age and obstetric and gynecological history were registered and the sample women were categorized by their variables. Length and thickness measurements were standardized.

Results

A total of 102 MRI studies were included, with a mean age of 41; 24.5% were nulligravida, the rest primi- or multigravida. Vaginal delivery was the most common type (49.35%), 16.88% had a cesarean section, and 31.17% had mixed delivery. 74.5% of the women were premenopausal. The mean RVS length was 73.2 ± 15.3 mm, with a thickness of 2.8 ± 1.7, 2.2 ± 1.2, and 2.5 ± 1.3 mm for the upper, middle, and lower thirds respectively. There were tendencies to increase the length of the RVS, and the thickness of the upper and middle thirds in the non-pregnancy and the at-least-one-pregnancy groups; to increase the length and middle-third thickness in those with mixed delivery, and increased upper- and lower-third thickness in those with only a cesarean section. Multiparous women with vaginal delivery had significantly longer and thicker RVS than primiparous. Premenopausal women had significantly longer RVS with a tendency to lose thickness toward postmenopause.

Conclusions

The morphology of RVS can be modified by different factors such as age, number of pregnancies, number of births, and estrogenic exposure. This structure should be evaluated and taken into account in preoperative management and surgical technique planning.

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Acknowledgements

The authors thank Armando Franco for his help in the editing of the figure in this manuscript.

Funding

There was no external funding; resources were provided by the Department of Human Anatomy, UANL.

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Authors and Affiliations

  1. Human Anatomy Department, School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico

    María Alejandra Rodríguez-Abarca, David De la Fuente-Villarreal, Guillermo Jacobo-Baca, Alejandro Quiroga-Garza, Rodrigo Enrique Elizondo-Omaña & Santos Guzman-Lopez

  2. Radiology and Imaging Department, University Hospital “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León (U.A.N.L.), Avenida Francisco I. Madero y Gonzalitos s/n Colonia Mitras Centro C.P, 64460, Monterrey, Nuevo León, Mexico

    Edgar Guillermo Hernández-Grimaldo & Ricardo Pinales-Razo

Authors
  1. María Alejandra Rodríguez-Abarca
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  2. Edgar Guillermo Hernández-Grimaldo
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  3. David De la Fuente-Villarreal
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  4. Guillermo Jacobo-Baca
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  6. Ricardo Pinales-Razo
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  7. Rodrigo Enrique Elizondo-Omaña
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  8. Santos Guzman-Lopez
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Contributions

M.A. Rodríguez-Abarca: methodology, data collection, validation, writing (review and editing); Edgar Guillermo Hernández-Grimaldo: methodology, data collection, validation, writing (review and editing); D. De la Fuente-Villarreal: methodology, validation, writing (review), supervision, project administration; G. Jacobo-Baca: conceptualization, methodology, validation, writing (review), supervision, project administration; A. Quiroga-Garza: conceptualization, methodology, data collection, validation, writing (review and editing), supervision, project administration; R. Pinales-Razo: methodology, writing (review), supervision, project administration; R.E. Elizondo-Omaña: methodology, writing (review and editing), supervision, project administration; S. Guzman-Lopez: methodology, writing (review), supervision, project administration.

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Correspondence to Alejandro Quiroga-Garza.

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Rodríguez-Abarca, M.A., Hernández-Grimaldo, E.G., De la Fuente-Villarreal, D. et al. Gynecological influencing factors on the rectovaginal septum’s morphology. Int Urogynecol J 32, 1427–1432 (2021). https://doi.org/10.1007/s00192-020-04376-4

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