OBJECTIVES: The objective of the study is to clarify potential risks to the dorsal nerve of the clitoris (DNC) and obturator canal using different minimally invasive slings. STUDY DESIGN: Ten embalmed hemipelves were dissected to demonstrate the course of the DNC and the obturator canal. On each cadaver, tension-free vaginal tape (TVT), transobturator in-out (TVT-O) and transobturator out-in (Monarc) procedures were performed. Distances between the DNC and the obturator canal to the different devices were measured. RESULTS: The DNC passes beneath the pubic bone at a distance of 14.3 +/- 4.7 mm of the midline. The distances of the different devices to the DNC were similar. The distance to the obturator canal was significantly different, with TVT being the furthest (40.1 +/- 3.7 mm) and TVT-O the closest (19.3 +/- 3.1 mm; p < 0.0001). CONCLUSION: Given the course of the DNC along the medial aspect of the ischiopubic ramus, the out-in technique may be safer. The in-out technique is the closest to the obturator canal.
OBJECTIVES: The objective of the study is to clarify potential risks to the dorsal nerve of the clitoris (DNC) and obturator canal using different minimally invasive slings. STUDY DESIGN: Ten embalmed hemipelves were dissected to demonstrate the course of the DNC and the obturator canal. On each cadaver, tension-free vaginal tape (TVT), transobturator in-out (TVT-O) and transobturator out-in (Monarc) procedures were performed. Distances between the DNC and the obturator canal to the different devices were measured. RESULTS: The DNC passes beneath the pubic bone at a distance of 14.3 +/- 4.7 mm of the midline. The distances of the different devices to the DNC were similar. The distance to the obturator canal was significantly different, with TVT being the furthest (40.1 +/- 3.7 mm) and TVT-O the closest (19.3 +/- 3.1 mm; p < 0.0001). CONCLUSION: Given the course of the DNC along the medial aspect of the ischiopubic ramus, the out-in technique may be safer. The in-out technique is the closest to the obturator canal.
Authors: R Basson; J Berman; A Burnett; L Derogatis; D Ferguson; J Fourcroy; I Goldstein; A Graziottin; J Heiman; E Laan; S Leiblum; H Padma-Nathan; R Rosen; K Segraves; R T Segraves; R Shabsigh; M Sipski; G Wagner; B Whipple Journal: J Urol Date: 2000-03 Impact factor: 7.450
Authors: Ercan Yeni; Doğan Unal; Ayhan Verit; Hasan Kafali; Halil Ciftci; Mehmet Gulum Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2003-11-25
Authors: Alison De Souza; Peter L Dwyer; Anna Rosamilia; Richard Hiscock; Yik N Lim; Christine Murray; Elizabeth Thomas; Christine Conway; Lore Schierlitz Journal: Int Urogynecol J Date: 2011-07-21 Impact factor: 2.894
Authors: José R Sañudo; Rosa Mirapeix; Marc Rodriguez-Niedenführ; Eva Maranillo; Ian G Parkin; Teresa Vázquez Journal: Int Urogynecol J Date: 2011-06-08 Impact factor: 2.894