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Surgical anatomy of the uterosacral ligament

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Abstract

Introduction and hypothesis

This study aims to elucidate and expand current knowledge of the uterosacral ligament (USL) from a surgical viewpoint.

Methods

Studies were performed on 12 unembalmed cadaveric pelves and five formalin-fixed pelves.

Results

The USL, 12–14-cm long, can be subdivided into three sections: (1) distal (2–3 cm), intermediate (5 cm), and proximal (5–6 cm). The thick (5–20 mm) distal section, attached to cervix and upper vagina, is confluent laterally with the cardinal ligament. The proximal section is diffuse in attachment and generally thinner. The relatively unattached intermediate section is wide, and thick, well defined when placed under tension, more than 2 cm from the ureter and suitable for surgical use. The strength of the USL is perhaps derived not only from the ligament itself, but also from the addition of extraperitoneal connective tissue.

Conclusions

The USL can be subdivided into three sections according to thickness and attachments with the intermediate section suitable for surgical use, particularly for vaginal vault support.

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Authors and Affiliations

  1. School of Medical Sciences, University of New South Wales, Kensington, NSW, Australia

    Dzung Vu, Bernard T. Haylen & Kelly Tse

  2. Douglas, Hanly Moir Pathology, North Ryde, NSW, Australia

    Annabelle Farnsworth

  3. Suite 904, St Vincent’s Clinic, 438 Victoria Street, Darlinghurst, 2010, NSW, Australia

    Bernard T. Haylen

Authors
  1. Dzung Vu
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  2. Bernard T. Haylen
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  3. Kelly Tse
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  4. Annabelle Farnsworth
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Correspondence to Bernard T. Haylen.

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Vu, D., Haylen, B.T., Tse, K. et al. Surgical anatomy of the uterosacral ligament. Int Urogynecol J 21, 1123–1128 (2010). https://doi.org/10.1007/s00192-010-1147-8

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  • DOI: https://doi.org/10.1007/s00192-010-1147-8

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