OBJECTIVE: The objective of the study was to characterize anatomic relationships of uterosacral ligament suspension (USLS) sutures. STUDY DESIGN: The relationship of USLS sutures to the ureters, rectal lumen, and sidewall neurovascular structures was examined in 15 unembalmed female cadavers. RESULTS: The mean distance of the proximal sutures to the ureters and rectal lumen was 14 mm (range, 0-33) and 10 mm (range, 0-33), respectively. The mean distance of the distal sutures to the ureters was 14 mm (range, 4-33) and to the rectal lumen 13 mm (range, 3-23). Right sutures were noted at the level of S1 in 37.5%, S2 in 37.5%, and S3 in 25% of specimens. Left sutures were noted at the level of S1 in 50%, S2 in 29.2%, and S3 in 20.8% of cadavers. Of 48 sutures passed, 1 entrapped the S3 nerve. Sutures perforated the pelvic sidewall vessels in 4.1% of specimens. CONCLUSION: USLS sutures can directly injure the ureters, rectum, and neurovascular structures in the pelvic walls.
OBJECTIVE: The objective of the study was to characterize anatomic relationships of uterosacral ligament suspension (USLS) sutures. STUDY DESIGN: The relationship of USLS sutures to the ureters, rectal lumen, and sidewall neurovascular structures was examined in 15 unembalmed female cadavers. RESULTS: The mean distance of the proximal sutures to the ureters and rectal lumen was 14 mm (range, 0-33) and 10 mm (range, 0-33), respectively. The mean distance of the distal sutures to the ureters was 14 mm (range, 4-33) and to the rectal lumen 13 mm (range, 3-23). Right sutures were noted at the level of S1 in 37.5%, S2 in 37.5%, and S3 in 25% of specimens. Left sutures were noted at the level of S1 in 50%, S2 in 29.2%, and S3 in 20.8% of cadavers. Of 48 sutures passed, 1 entrapped the S3 nerve. Sutures perforated the pelvic sidewall vessels in 4.1% of specimens. CONCLUSION: USLS sutures can directly injure the ureters, rectum, and neurovascular structures in the pelvic walls.
Authors: Elisha Jackson; Jorge A Bilbao; Robert W Vera; Zuber D Mulla; Veronica T Mallett; T Ignacio Montoya Journal: Int Urogynecol J Date: 2015-07-15 Impact factor: 2.894
Authors: T Ignacio Montoya; Hillary I Luebbehusen; Joseph I Schaffer; Clifford Y Wai; David D Rahn; Marlene M Corton Journal: Int Urogynecol J Date: 2012-05-16 Impact factor: 2.894