OBJECTIVE: The study was to explore the safety, firmness and convenience of the fascia around the ischial spine as a new fixation site for the vaginal fornix. METHODS: Between June 2007 and January 2008, detailed dissections and related measurements of the regions around the ischial spine were performed on 10 Chinese female cadavers (3 unembalmed and 7 embalmed cadavers). At the same time, the sacrospinous ligament, the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were exposed and the pull-out strength sequentially tested using a digital push-pull force gauge. RESULTS: The fascia on the ischial spine was firm and strong, with a thickness of 3 about mm. No major vessels or nerves were observed on the ischial spine. The greatest pullout strengths of the sacrospinous ligament, the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were (102 +/- 26), (64 +/- 15), (33 +/- 8) and (32 +/- 6) N, respectively. CONCLUSION: The fascia at 1 cm from anterior lateral ischial spine, free of major vessels and nerves, is safe and strong and could be used as a new site for suspension in vaginal prolapse.
OBJECTIVE: The study was to explore the safety, firmness and convenience of the fascia around the ischial spine as a new fixation site for the vaginal fornix. METHODS: Between June 2007 and January 2008, detailed dissections and related measurements of the regions around the ischial spine were performed on 10 Chinese female cadavers (3 unembalmed and 7 embalmed cadavers). At the same time, the sacrospinous ligament, the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were exposed and the pull-out strength sequentially tested using a digital push-pull force gauge. RESULTS: The fascia on the ischial spine was firm and strong, with a thickness of 3 about mm. No major vessels or nerves were observed on the ischial spine. The greatest pullout strengths of the sacrospinous ligament, the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were (102 +/- 26), (64 +/- 15), (33 +/- 8) and (32 +/- 6) N, respectively. CONCLUSION: The fascia at 1 cm from anterior lateral ischial spine, free of major vessels and nerves, is safe and strong and could be used as a new site for suspension in vaginal prolapse.
Authors: Omar F Dueñas-Garcia; Gina M Sullivan; Katherine Leung; Kristen L Billiar; Michael K Flynn Journal: Int Urogynecol J Date: 2017-06-20 Impact factor: 2.894