American journal of obstetrics and gynecology · 2012
Anatomic relationships of single-incision midurethral slings.
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Montoya T Ignacio, Street Jennifer J, Corton Marlene M
Аннотация
OBJECTIVE: The objective of the study was to evaluate the anatomic relationships of anchor points of single-incision midurethral slings with 2 common placement trajectories.
STUDY DESIGN: In 30 female pelvic halves, a probe was introduced through a suburethral tunnel following 45° and 90° angle trajectories. The corresponding anchor points were tagged. Distances to the obturator canal, accessory obturator vessels, dorsal vein of clitoris, and external iliac vein were recorded.
RESULTS: Both suburethral tunnel trajectories and their respective anchor points remained caudad to the obturator internus muscle in 100% of dissections. The closest distance between either anchor point to the obturator canal was 1.6 cm. The closest distance from the 45° and 90° anchor points to the accessory obturator vessels was 1.6 and 1.5 cm, respectively.
CONCLUSION: The anchor points of single-incision midurethral slings are in close proximity to vascular structures that could be injured with inadvertent entry into the retropubic space.
STUDY DESIGN: In 30 female pelvic halves, a probe was introduced through a suburethral tunnel following 45° and 90° angle trajectories. The corresponding anchor points were tagged. Distances to the obturator canal, accessory obturator vessels, dorsal vein of clitoris, and external iliac vein were recorded.
RESULTS: Both suburethral tunnel trajectories and their respective anchor points remained caudad to the obturator internus muscle in 100% of dissections. The closest distance between either anchor point to the obturator canal was 1.6 cm. The closest distance from the 45° and 90° anchor points to the accessory obturator vessels was 1.6 and 1.5 cm, respectively.
CONCLUSION: The anchor points of single-incision midurethral slings are in close proximity to vascular structures that could be injured with inadvertent entry into the retropubic space.