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De Lancy levels

DeLancey describes the anatomy of vaginal vault prolapse in terms of 3 levels of support 


  • Level I involves the support of the upper vagina and cervix or the vaginal cuff (in a woman who has undergone total hysterectomy) by the cardinal-uterosacral ligament complex.
  • Level II denotes the lateral support of the mid vagina to the arcus tendineus fascia pelvis (white line).
  • Level III is represented by the fusion of tissue along the base of the urethra and the distal rectovaginal septum to the perineal body.

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