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<p>Since the publication of John DeLancey’s “Levels of vaginal support”, the mechanisms underlying pelvic organ prolapse (POP) have been extensively researched and are now well understood. Historically, Level&#xa0;III of the pelvic floor received little attention. It is only in recent years that increasing evidence has emerged regarding the clinical significance of this anatomical region. Several studies clearly indicate that Level&#xa0;III warrants careful consideration in the treatment and postoperative care of POP, and potentially even in its prevention. In routine gynecological examinations, the genital hiatus can serve as a&#xa0;clinical indicator of Level&#xa0;III integrity and function. A&#xa0;new model describes the functional interplay of the anatomical structures within Level&#xa0;III, facilitating a&#xa0;more comprehensive understanding of the region. This model may provide the foundation for further insights and the development of future, targeted, and standardized therapeutic options.</p>

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Level I und II sind klar – beachten wir Level III beim Genitaldeszensus zu wenig?

  • 期刊论文

  • 发表日期：

    2026年4月29日

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  • Matthias Pesendorfer,
  • Ayman Tammaa

摘要

Since the publication of John DeLancey’s “Levels of vaginal support”, the mechanisms underlying pelvic organ prolapse (POP) have been extensively researched and are now well understood. Historically, Level III of the pelvic floor received little attention. It is only in recent years that increasing evidence has emerged regarding the clinical significance of this anatomical region. Several studies clearly indicate that Level III warrants careful consideration in the treatment and postoperative care of POP, and potentially even in its prevention. In routine gynecological examinations, the genital hiatus can serve as a clinical indicator of Level III integrity and function. A new model describes the functional interplay of the anatomical structures within Level III, facilitating a more comprehensive understanding of the region. This model may provide the foundation for further insights and the development of future, targeted, and standardized therapeutic options.