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Carcinoma of the Vagina and Vulva
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Sadaf Ghaem-Maghami, Kostas Lathouras
The mons pubis is a pad of fat anterior to the pubic symphysis and covered by hair-bearing skin. The labia majora extend posteriorly from the mons on either side of the pudendal cleft into which the urethra and vagina open. They merge with one another and the perineal skin anterior to the anus. They consist largely of areolar tissue and fat. On their lateral aspects, the skin is pigmented and covered with crisp hairs. On the medial side, the skin is smooth and has many sebaceous glands. The labia minora are small folds of skin that lie between the labia majora and divide anteriorly to envelop the clitoris. The clitoris is an erectile structure analogous to the male penis. Partly hidden by the anterior folds of the labia minora, the clitoris consists of a body of two corpora cavernosa, lying side-by-side and connected to the pubic and ischial rami, and a glans of sensitive, spongy erectile tissue. The vestibule is that area between the labia minora into which the urethra and vagina open. The bulbs of the vestibule are elongated masses of erectile tissue lying on either side of the vaginal opening.
Knowledge Area 5: Antenatal Care
Published in Rekha Wuntakal, Ziena Abdullah, Tony Hollingworth, Get Through MRCOG Part 1, 2020
Rekha Wuntakal, Ziena Abdullah, Tony Hollingworth
The mons pubis arises from genital swellings. In females, the genital fold gives rise to the labia minora, and in males, the genital fold gives rise to ventral aspect of the penis. In females, the genital swellings give rise to the labia majora, and in males, the genital swellings give rise to scrotum. The urogenital grove gives rise to the vestibule. The clitoris arises from the genital tubercle.Further readingSarris I, Sangeeta A, Susan B. Training in Obstetrics and Gynaecology: The Essential Curriculum. Oxford, UK: Oxford University Press, 2009, pp. 391–416.
The development and anatomy of the female sexual organs and pelvis
Published in Helen Bickerstaff, Louise C Kenny, Gynaecology, 2017
The external genitalia are commonly called the vulva and include the mons pubis, labia majora and minora, the vaginal vestibule, the clitoris and the greater vestibular glands. The mons pubis is a fibro-fatty pad covered by hair-bearing skin that covers the bony pubic ramus.
Corset trunkoplasty is able to preserve postoperative abdominal skin sensation in massive weight loss patients
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Kathrin Bachleitner, Maximilian Mahrhofer, Friedrich Knam, Thomas Schoeller, Laurenz Weitgasser
Besides all the advantages regarding abdominal surface skin area sensibility in all qualities of sensation, the corset trunkoplasty technique ensures an improved hour-glass-like definition of the torso and is able to achieve an improved harmony of the entire trunk’s aesthetic unit [12,27]. Since massive weight loss does not only cause excess skin in the anterior trunk but circumferentially, body contouring surgery has to address both upper abdominal skin and the waist, using two directions for skin tensioning in a perpendicular orientation. The corset trunkoplasty technique uses the horizontal as well as the vertical axis to redistribute the skin after dermatolipectomy, which enables maximum tightening of the skin to create a more harmonic body shape. The en-bloc skin excisions, resembling a perpendicular letter ‘H’ incision pattern, allows a unique redistribution of the skin on the flanks, thereby tightening and flattening the back rolls as well. The technique furthermore enables an improvement of mons pubis ptosis in one stage without any change of patient positioning [27].
Puboplasty as an integral step in massive weight loss abdominal contouring: a retrospective assessment of results, stability, and patients’ satisfaction
Published in Journal of Plastic Surgery and Hand Surgery, 2022
Pierfranco Simone, Luca Savani, Paolo Marchica, Paolo Persichetti
Much attention is paid to the correction of the abdominal skin overhang following massive weight loss, often neglecting the pubis descent [3,4]. However, if pubic ptosis (with or without persistent fat deposits) is not adequately assessed and corrected, patients will become conscious of this condition following abdominoplasty and the overall improvement of the procedure may not be fully appreciated [5]. Matarasso and collegues identified the mons pubis as one of the abdominal related aesthetic units, advocating its reshaping during abdominoplasty [6]. Since then, puboplasty has evolved through different techniques, from the horizontal or vertical wedge excision in association or not with liposuction [3] to the use of liposuction only for pubis contouring, proposed by Hughes [7] and Pechevy [5]. Alter [8] advocated the undermining of the mons pubis up to the pubic symphysis and its suspension to the rectus fascia, associated with liposuction or open fat excision. Awadeen [9] described the use of exceeding deepithelialized pubic skin as a flap secured to the rectus fascia concomitant to the abdominoplasty. El Khatib [10] proposed different strategies depending on the severity of the ptosis, ranging from liposuction to deep lipectomy and subsequent pubic lift in a similar fashion as Bloom [11]. Finally, Marques [4] and Filho [12] suggested a resection-based monsplasty.
Safe monsplasty technique
Published in Journal of Plastic Surgery and Hand Surgery, 2018
Audrey Patoué, Antoine De Runz, Raphael Carloni, Sylvie Aillet, Eric Watier, Nicolas Bertheuil
Obesity is a public health problem. It is a chronic disease associated with the occurrence of many serious diseases, such as hypertension, diabetes, dyslipidemia, obstructive sleep apnea, arthrosis, cancer and major cardiovascular diseases. Obesity shortens life expectancy [1]. Weight loss can reduce the occurrence of these diseases, with improvement in patients’ health, life expectancy and quality of life [2]. After massive weight loss, patients consult plastic surgeons to achieve a supplementary step in quality of life improvement because redundant skin and folds create aesthetic and functional discomfort (e.g. difficulty in daily life with dressing, intimate hygiene, walking, psychosocial factors, self-esteem and sex life). Massive weight loss affects the support function of the superficial fascia due to distension caused by obesity and the resulting loss of elasticity due to histomorphological changes, such as the decrease in collagen [3]. Massive weight loss can also cause pubic ptosis. Although abdominoplasty or bodylift procedure can be performed, lack of consideration of the pubic region may create or increase discomfort in a patient. The mons pubis is a triangular aesthetic unit that is hairy, slightly domed, fatty and well individualized in the abdomen. Several classifications of ptosis of the mons pubis exist, including the El-Khatib classification (four grades) [4] and the Pittsburgh classification (four groups) [5].