Because of its proximity to the urethra, the anterior part of the arcus tendineus fasciae pelvis (ATFP) may be used in urethrosuspension procedures for urinary stress incontinence. In this study, 10 embalmed female cadaver hemipelves were dissected and their gross anatomy described. In females, the ATFP is a condensation of the endopelvic fascia. The anterior attachment of the ATFP is to the caudal inner surface of the body of the pubic bone at a site averaging 4 mm lateral to the pubic symphysis and covering an average area of 53 mm(2). Posteriorly, it attaches to the medial surface of the ischial spine. In nine of the 10 hemipelves the first anterior centimeters of the ATFP have a clear lateral fixation either to the lateral part of the levator ani muscle (n = 1), to the fascia covering the obturator internus muscle (n = 7), or to the obturator membrane (n = 1). Medially from the ATFP derives a 2-3-cm long flat fibrous attachment to the posterolateral aspect of the urethra. In eight unembalmed cadavers, the ATFP gave way at a pulling force of 8.2 kg (range = 3.5-11.5 kg). The ATFP resists caudal movement of the proximal anterior vaginal wall and the urethra in the upright posture and, therefore, may be suitable for urethrosuspension procedures.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/ca.10102 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Transvaginal Natural Orifice Transluminal Endoscopic Surgery Meshless Anterior Repair for the Treatment of Pelvic Organ Prolapse.
J Minim Invasive Gynecol
June 2022
Division of Gynecology, Department of Obstetrics and Gynecology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland (all authors).
Study Objective: To demonstrate the feasibility of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) meshless anterior repair for the treatment of pelvic organ prolapse (POP).
Design: Stepwise demonstration of the technique with narrated video footage.
Setting: The vNOTES approach is a recent and rapidly developing technique that allows safe endoscopic transvaginal treatment of benign uterine pathologies [1].
Tissue Fixation System ligament repair cures major pelvic organ prolapse in ageing women with minimal complications - a 10-year Japanese experience in 960 women.
Cent European J Urol
November 2021
Urogynecology Center, Shonan Kamakura General Hospital, Kamakura, Japan.
Introduction: Japan's ageing crisis has brought major prolapse and incontinence problems. We hypothesized the problem was collagen leaching out of ligaments which support organs and could be corrected by the TFS (Tissue Fixation System) minisling which uses 7 mm wide tapes to create new collagen for ligament reinforcement.We analysed our 10-year experience (2009-2019) with TFS minisling prolapse repair with regard to one main question: "Is this technology of benefit to the ageing Japanese population?".
View Article and Find Full Text PDFVaginally Assisted Laparoscopic Urethrolysis and Mesh Excision after Tension-free Vaginal Tape.
J Minim Invasive Gynecol
December 2021
Department of Obstetrics and Gynecology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey (all authors).
Study Objective: To present technique of vaginally assisted laparoscopic urethrolysis and mesh excision after tension-free vaginal tape.
Design: Demonstration video.
Setting: Despite the Food and Drug Administration's warning to limit the use of mesh, midurethral sling surgery (MUS) has not significantly decreased, but operations for complications have increased 3 times [1].
Hood Technique for Robotic Radical Prostatectomy-Preserving Periurethral Anatomical Structures in the Space of Retzius and Sparing the Pouch of Douglas, Enabling Early Return of Continence Without Compromising Surgical Margin Rates.
Eur Urol
August 2021
Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
Background: A common side effect following radical prostatectomy is urinary incontinence. Here, we describe a novel surgical technique to reduce postoperative urinary incontinence and facilitate early return of continence.
Objective: To describe the novel "hood technique" for robotic-assisted radical prostatectomy (RARP).
Simple suturing of the bladder neck muscle layer at the vesicourethral anastomosis site to the dorsal vein complex during anterior reconstruction led to a better postoperative urinary continence after robot-assisted laparoscopic prostatectomy.
Scand J Urol
December 2020
Department of Urology, Nara Prefecture General Medical Center, Nara, Japan.
Objectives: To elucidate whether a modified technique for anterior reconstruction could improve urinary continence after robot-assisted laparoscopic radical prostatectomy (RALP).
Methods: Among 325 consecutive patients who underwent RALP at our hospital, 297 patients were included in this retrospective study, who had complete records including the status of postoperative urinary continence. Among these 297 patients, 194 underwent anterior reconstruction by suturing the lateral bladder wall to the arcus tendineus of the pectineal fascia without fixation of the vesicourethral anastomosis site to the dorsal vein complex (DVC) (lateral-suture group).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!