Skip to main content
. Author manuscript; available in PMC: 2010 Jul 22.
Published in final edited form as: J Biomech. 2009 May 29;42(10):1371–1377. doi: 10.1016/j.jbiomech.2009.04.043

Figure 11.

Figure 11

A conceptual model of the pathomechanics of cystocele. Inputs to the support system include the intensity (α) of the pubovisceral (“PV”) muscle contraction (yielding tension, T), intraabdominal pressure (pa) and atmospheric pressure (po). ‘pa’ acts on the surface of the levator ani muscle so as to increase T and help determine total hiatal area. It can also drive the uterus partially into the hiatus (dashed line), leaving the remaining hiatal aperture to be spanned by the distal anterior vaginal wall (AVW) and exposed to the pressure differential (ΔpAVW). The resulting tension (TAVW) in the AVW then applies tension to its Apical and Paravaginal Supports helping to determine the size of the resulting cyctocele (dAVW). Birth damage, aging, collagen/elastin disorders and hormonal effects are all postulated to affect the properties of given structures.