The macro-anatomy of the vaginal outlet wall differs from the vaginal
wall: A prospective, cadaveric case series study
Abstract
Objectives To describe and document the anatomical and histological
architecture of the vaginal outlet wall. Design A prospective
observational case series study. Setting International centers.
Population Twelve fresh human female cadavers. Methods Female corpses
were subjected to stratum-by-stratum, macro-, and micro-anatomical
dissections in sagittal, transverse, and coronal planes. Multiple
excisional biopsies were obtained from the vaginal outlet wall at 12, 3,
6, and 9 o’clock locations for histological examination. Digital
photograms documented the anatomical and histological features. Primary
Outcome measures gross, topographic anatomy and characteristic
histologic features of the vaginal outlet wall. Results The vaginal
outlet wall (VOW) was positioned in the vertical orientation and fused
with horizontally located the vaginal wall at the hymeneal plate level.
The hymeneal membrane and ring were not attached directly to the vaginal
wall. VOW has three identifiable anatomical-histological layers a) the
hymeneal membrane, b) the hymeneal ring (cartilage) with different
anatomy and histology than the vaginal wall, and c) the hymeneal plate
(the deep level of VOW), which connects to the vaginal wall. Conclusions
The vaginal outlet wall is an anatomical structure consisting of the
hymeneal membrane, hymeneal ring (cartilage), and hymeneal plate. This
structure is in vertical topographic orientation. Anatomically and
histologically, it differs from the vaginal wall, which fuses with the
deep layer of the hymeneal plate.