First introduced in France in 1965, the colpocystourethro-gram combines opacification of the bladder, urethra, and vagina.2 Modified and made popular in the mid 1970s, the colpocystourethrogram is a dynamic study of pelvic support and function. The anatomical relationships among the bladder, urethra, and vagina may be demonstrated, and, when combined with proctography, may be even more useful in outlining the anatomy of the normal pelvis and of complex pelvic organ prolapse.

The accuracy of dynamic colpocystoproctography is even further enhanced by opacifying the small bowel. The patient drinks oral barium 2 hours before the examination. With the vagina, bladder, small intestine, and rectum opacified, the vaginal axis may be measured at rest and with straining, and any prolapse of the anterior, middle, or posterior vaginal compartment is evident. Moreover, the examiner should be able to distinguish among various organs that may prolapse into a widened rectovaginal space, differentiating enterocele from sigmoidocele, further refining the operative approach.

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