Surgical and Radiologic Anatomy

, Volume 22, Issue 2, pp 73–79

Tendinous arch of the pelvic fascia application to the technique of paravaginal colposuspension

  • B. Mauroy
  • E. Goullet
  • X. Stefaniak
  • J. L. Bonnal
  • N. Amara
Anatomic bases of medical, radiological and surgical techniques

DOI: 10.1007/s00276-000-0073-8

Cite this article as:
Mauroy, B., Goullet, E., Stefaniak, X. et al. Surg Radiol Anat (2000) 22: 73. doi:10.1007/s00276-000-0073-8

Abstract

The authors give a description of the anatomy and topography of the tendinous arch of the pelvic fascia (TAPF), in order to facilitate its location during surgery. 35 TAPF in 25 female cadavers were dissected. The reproducibility of the landmarks was then verified at laparotomy. The TAPF can be easily identified and its resistance remains constant, even when the pelvic floor is hypotrophic. Its anterior extremity (d2) is at about 46 mm on a line perpendicular to the anterior edge of the pectineal ligament (35–55 mm), next to the pubovesical ligament. Its median part (d1) is perpendicular to the obturator foramen at a site located at an average of 30 mm below the obturator foramen (25–50 mm). Its posterior end is located at the ischial spine. These anterior landmarks, the only ones useful during surgery, allow its very easy location with the palmar surface of the finger. Testard and Delancey demonstrated the major role of the TAPF in stabilising the urethra submitted to strain. Richardson described a technique of paravaginal suspension for curing paravaginal fascial defect. The TAPF has never been well described, but his work allows its easy location during surgery. The suture of the vagina to the TAPF allows a more physiologic and stronger suspension of the bladder neck than other classical techniques.

Key words

Vagina Urethra Bladder neck Pelvic floor disorders Stress incontinence Cystocele 

Copyright information

© Springer-Verlag France 2000

Authors and Affiliations

  • B. Mauroy
    • 1
  • E. Goullet
    • 1
  • X. Stefaniak
    • 1
  • J. L. Bonnal
    • 1
  • N. Amara
    • 1
  1. 1.Institute of AnatomyFaculty of MedicineLille cedexFrance

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