Interpretation
Anatomy
The present study findings show that the vaginal outlet wall and its
tensile resistance are not directly connected to the posterior
perineum; therefore, clinicians need to know that cutting the posterior
perineum in traditional episiotomies is questionable. The current
investigation shows that the hymeneal ring (cartilage) is the tissue
responsible for the resistance during fetal vaginal delivery.
Furthermore, there are several reports in the medical literature about
gynecological entities that are specifically related to the vaginal
outlet, such as “vulvar outlet stenosis” (vaginal stenosis), which is
recognized as causing superficial dyspareunia.6-8Those authors postulated that the vulvar outlet participates in the
pelvic organ prolapse; therefore, it should be evaluated when the
posterior-distal vaginal wall relaxation is present. However, they did
not present the gross, topographic, or surgical anatomy.6-8