Anatomic relationships of the "top-down" mid-urethral sling.

Objective: To determine the anatomic relationships between the "top-down" mid-urethral sling (MUS) and pelvic structures.

Study Design: Placement of the sling needle delivery device was performed in 10 cadaveric hemi-pelves. The distances between major structures in the pelvis and the needle delivery device were recorded.

Results: The mean distances are as follows: mid pubis 1.71 (+/- 0.25) cm, bladder neck 1.66 (+/- 0.37) cm, urethral orifice 3.96 (+/- 0.52) cm, obturator foramen 3.90 (+/- 0.43) cm, inferior epigastric vessels 3.50 (+/- 0.62) cm, accessory obturator vessels 3.53 (+/- 0.36) cm and external iliac vein 4.02 (+/- 0.42) cm.

Conclusion: Major pelvic structures are in close proximity to the needle delivery device in a top-down mid-urethral sling.