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Re: rectocele repair / Fascia Denonviere From: Arthur W. Curtis, Jr. (artcurtis@juno.com) Tue Jan 21 21:19:40 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: PDBurstein@aol.com: "Re: Neonatal circumcision" Previous message: Garry E. Siegel: "Re: Sexual Politics" I heard Nichols once describe the fascia of Denonviere (ya gotta hear him pronounce it) as having its origin from the peritoneum of the posterior cul de sac, the lowest part that is obliterated later in fetal or early newborn life. The "fascia" in other words was never fascia, but is merely the remnants of two layers of obliterated peritoneum. He showed several histologic slides to demonstrate the structure of the fascia. His point of surgery recreating of anatomy, supported by the fact that the levator muscle was never in the midline between the vagina and rectum, is the basis of his posterior repair merely excising the full thickness of the excess vaginal mucosa in the midline without approximating the levators over the rectum. I hope I am describing his premise accurately. -- Arthur Curtis, MD FACOG 100 Central Street Worcester, MA 01608 ArtCurtis@Juno.com -- On Tue, 21 Jan 1997 12:43:10 -0600 Robert Brenner <robbrenner@earthlink.net> writes: >According to Nichols, the support of the posterior compartment of the >vagina is by the fascia of Denonviere. This fascia is on the undersurface of >the vagina so that by suturing the vaginal mucosa together this brings the >fascia together for support. > >I'm not so sure I totally agree with all this since I tend to take >discussions of "my surgical technique" with a grain of salt. However, >Nichols does have some histologic evidence to support his theory but >how strong is that fascia anyway. I also agree with the problem of >constricted vagina. > >Robert Brenner MD FACOG >Baltimore MD >Robbrenner@earthlink.net > Next message: PDBurstein@aol.com: "Re: Neonatal circumcision" Previous message: Garry E. Siegel: "Re: Sexual Politics"

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