Lymphovascular Supply

The descending branch of the uterine artery supplies the upper vagina. The lower vagina is supplied by branches of the internal pudendal artery. The veins of the vagina drain to the uterovaginal plexus, which eventually drains to the internal iliac veins.

The lymphovasular supply of the vagina is closely related to that of the cervix and vulva. Superiorly, lymphatics drain along the uterine artery into the external iliac lymph nodes. In the mid-vagina the lymphatic drainage terminates in the hypogastric nodes while the inferior aspect of the vagina terminates in the inguinal lymph nodes.

Primary pathology of the vagina is relatively rare. Symptomatology related to primary vaginal disease may include a mass or feeling of discomfort, vaginal bleeding or discharge, dyspareunia (painful coitus) or postcoital bleeding. Occasionally, primary vaginal disease is discovered at colposcopic examination. Many of the signs and symptoms experienced by women with malignant vaginal lesions are similar to those encountered with cervical cancer.

Usually, vaginal tumours can be directly visualised. Dysplastic squamous lesions (known as vaginal intraepithelial neoplasia, VAIN) may be seen at colposcopic examination. With suspected primary vaginal malignancies, pelvic MRI is used to assess the stage of the tumour and the presence or absence of pelvic or inguinal lymphadenopathy. Exfoliative cytology with microscopic examination of cells obtained by aspiration of the vaginal pool is occasionally used in the diagnosis of vaginal lesions, but this practice is not widespread.

0 0

Post a comment