Vaginal rugae are structures of the vagina that are transverse ridges formed out of the supporting tissues and vaginal epithelium in females.[1] Some conditions can cause the disappearance of vaginal rugae and are usually associated with childbirth and prolapse of pelvic structures. The rugae contribute to the resiliency and elasticity of the vagina and its ability to distend and return to its previous state.[2][3][4] These structures not only allow expansions and an increase in surface area of the vaginal epithelium, they provide the space necessary for the vaginal microbiota. The shape and structure of the rugae are supported and maintained by the lamina propria of the vagina and the anterior and posterior rugae.[5]
The anterior and posterior columnae rugae are transverse vaginal support structures between which the transverse rugae exist. The cross section of the vagina normally forms a shape that resembles the letter 'H' due to these structures.[6]
Vaginal rugae disappear in older women and those with an estrogen deficiency.[7] The rugae can disappear with anterior vaginal wall prolapse which can occur when supports to the portion located between the vagina and bladder are damaged and the bladder bulges into the vaginal lumen. Vaginal self-examination includes visualizing the presence of vaginal rugae.[8] Anatomists identified rugae of the vagina as early as 1824.[9]