Variability of the retropubic space anatomy in female cadavers

Objective To characterize the anatomic relationships of clinically relevant structures in the retropubic space. Study Design Detailed dissections were performed in 15 female cadavers. Results The obturator vein was the closest of the obturator neurovascular structures to the ischial spine, median di...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2009-11, Vol.201 (5), p.524.e1-524.e5
Main Authors: Pathi, Sujatha D., MD, Castellanos, Mario E., MD, Corton, Marlene M., MD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Cadaver
Female
Gynecology. Andrology. Obstetrics
Humans
Iliac Vein
internal iliac vein
Medical sciences
Obstetrics and Gynecology
Pelvis - anatomy & histology
retropubic space
vesical venous plexus
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Summary:Objective To characterize the anatomic relationships of clinically relevant structures in the retropubic space. Study Design Detailed dissections were performed in 15 female cadavers. Results The obturator vein was the closest of the obturator neurovascular structures to the ischial spine, median distance 3.4 cm (range, 1.8–4.8 cm). The vesical venous plexus included 2-5 rows of veins that coursed within the paravaginal tissue parallel to the bladder and drained into the internal iliac veins. The internal iliac vein was formed cephalad to the level of the ischial spine; the closest distance between these structures was 3.8 cm (1.6-6.2 cm). Conclusion The complexity and proximity of the large internal iliac venous system to the bony landmarks used for passage of trocars is described in this study. A thorough understanding of the vascular anatomy in this space should help avoid serious operative complications.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2009.07.020