The relationship between anthropometric measurements and the bony pelvis in African American and European American women.

INTRODUCTION AND HYPOTHESIS: The bony pelvis anatomy is highly variable. This study aims to examine the relationship between anthropometric measurements and the size of the adult female bony pelvis. METHODS: Three-dimensional points of all pertinent landmarks of 96 adult female bony pelvises were obtained and the true conjugate, interspinous distance, intertuberous distance, and pelvic inlet and outlet areas were calculated. The relationship between these measurements and height and multiple anthropometric measurements were evaluated using Pearson's correlation coefficient (r). RESULTS: Multiple anthropometric measurements were significantly correlated with the true conjugate and pelvic inlet and outlet areas, but not with the interspinous or intertuberous widths. Height had a greater correlation with pelvic areas than any other anthropometric measure considered, even after controlling for race. There were no significant differences in pelvic areas between races. CONCLUSIONS: Height and other anthropometric measurements were significantly correlated with the true conjugate and pelvic inlet and outlet areas.

Variation of the obturator foramen and pubic arch of the female bony pelvis.

OBJECTIVE: The purpose of this study was to determine dimensions of the obturator foramen and pubic arch of the female pelvis and to assess for variability. STUDY DESIGN: Ninety-six female pelvises were selected from the Cleveland Natural History Museum. The obturator foramen area, pubic arch angle, pubic ramus, pubic symphysis, and anterior urogenital triangle area were measured. Linear regression was used to evaluate independent associations. RESULTS: There was considerable variability of the bony architecture. The mean obturator foramen area was 12.2 +/- 2.1 cm(2) (range, 7.38-18.22 cm(2)). After controlling for height, the pubic ramus width, pubic symphysis length, and interobturator foramina distance were significantly greater in European American women compared with African American women. Obturator foramen area increased with increasing height (P = .0008) but was not associated with race. CONCLUSION: There is considerable variability in the bony architecture of the obturator foramen and pubic arch of the female pelvis. Race and height may account for some of these variabilities.

Complications of neglected vaginal pessaries: case presentation and literature review.

Vaginal pessaries are often used as first-line management of pelvic organ prolapse in women who are poor surgical candidates or who decline surgical repair. Mostly, pessaries are well tolerated but when neglected may lead to serious complications including vesicovaginal and rectovaginal fistulas. An 89-year-old woman presented with a large vesicovaginal fistula resulting from a Gellhorn pessary that had been neglected for 3 years. The base of the pessary had migrated completely inside the bladder and the fistulous opening measured 4 cm. The pessary was extracted under anesthesia using a Schuchardt incision to increase exposure. After 6 weeks of vaginal estrogen treatment, the fistula was successfully repaired using the Latzko partial colpocleisis technique. Neglect of a vaginal pessary can lead to serious complications. Patient education, local estrogen treatment, excellent fitting, and careful follow-up are of paramount importance in prevention of such complications.