Vagina

The human vagina is a fibromuscular tube specialized for reception of the penis during coitus and delivery of the developed fetus during parturition. It needs to be mobile and distensible. The upper two-thirds of the vagina is almost horizontal in the standing position. In contrast, the lower one-third is nearly vertical.

Histologically, the vaginal wall is composed of three layers. The most superficial layer is stratified squamous epithelium. The middle layer is the lamina propria and consists of collagen and elastin. The lamina propria contains no glands. Vaginal lubrication is via a transudate from the vessels, cervix, and from the Bartholin's and Skene's glands. Coursing through the lamina propria are small blood vessels. The innermost layer is the muscularis that consists of smooth muscle. The histology of the vaginal layers may change with menopause.

The presence of a true fascia between the vagina and adjacent organs has been debated. Although at the time of surgery there appears to be an identifiable fascial plane, Weber and Walters2 and DeLancey3 have concluded that there is no fascia present histologically. Between adjacent organs is primarily vaginal muscularis. However, an extension of the connective tissue of the perineal body forms what some have called the rectovaginal fascia. This tissue extends 2 to 3 cm cephalad from the hymenal ring along the posterior vaginal wall.

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