Vaginal Anatomy for the Pelvic Surgeon

Abstract

The word vagina, derived from the Latin word for “sheath,” describes the hollow fibromuscular sheath extending from the vestibule to the cervix. The walls of the vagina are in apposition except at the apex where it is held open by the cervix (1). Vaginograms from normal women show that the vagina takes a slightly S-shaped course, curving at the perineum and cervix with a horizontal plane over the levator plate. Vaginal dimensions based on vaginal casts and radiographic studies show five different vaginal shapes (Figure 1.1) with dimensions ranging from 8.4 to 11.3 cm in length and 2.1 to 5.0 cm in diameter (2,3). The anterior vaginal wall is shorter than the posterior wall given the differences in forniceal length. The anterior vaginal length is approximately 6 to 9 cm in comparison to the posterior vaginal length of 8 to 12 cm (4).