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Anatomical relationship and fixation of tension-free vaginal tape Secur

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Abstract

Objective

The objective is to describe the anatomical localisation of tension-free vaginal tape Secur (TVT-S) in the H-position regarding possible injury of vessels and fixation site.

Methods

We placed TVT-S inserters bilaterally in 14 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle (obturator nerve and obturator vessels).

Results

In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 3.05 cm (standard deviation (SD) 1.18 cm) on the left, 3.07 cm (SD 1.17 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 46.4%. In fresh frozen bodies, results were fundamentally similar. Injury of variable vessels can occur.

Conclusion

There is a minimal risk of injury to the obturator bundle during TVT-S; however, there is a significant risk of inserting the TVT-S inserter into the obturator fossa. The position of TVT-S does not change significantly after legs mal-positioning.

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Acknowledgements

We would like to thank to I. Vítková MD, Chief of Institute of Pathology of the First Faculty of Medicine and General Teaching Hospital, for allowing us to perform research at the Institute of Pathology, for scheduling the dissections and coping with our demands. We would also like to thank to I. Helekal, academic artist of Institute of Anatomy of the First Faculty of Medicine, for drawing Fig. 1. This study was supported by the Internal Grant Agency of the Ministry of Health of the Czech Republic, grant NR/8815-3/2006, GIGH-0651-00-3-223.

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Authors and Affiliations

  1. First Faculty of Medicine and General Teaching Hospital, Department of Gynaecology and Obstetrics, Charles University in Prague, Apolinarska 18, 12000, Prague, Czech Republic

    Petr Hubka, Jaromir Masata & Alois Martan

  2. First Faculty of Medicine, Institute of Anatomy, Charles University in Prague, Prague, Czech Republic

    Ondrej Nanka & Milos Grim

  3. Academy of Sciences of the Czech Republic, Institute of Computer Science, EuroMISE Center, Prague, Czech Republic

    Jana Zvarova

Authors
  1. Petr Hubka
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  2. Jaromir Masata
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  3. Ondrej Nanka
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  4. Milos Grim
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  5. Alois Martan
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  6. Jana Zvarova
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Correspondence to Petr Hubka.

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Hubka, P., Masata, J., Nanka, O. et al. Anatomical relationship and fixation of tension-free vaginal tape Secur. Int Urogynecol J 20, 681–688 (2009). https://doi.org/10.1007/s00192-009-0815-z

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  • DOI: https://doi.org/10.1007/s00192-009-0815-z

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