Anatomic relationships of single-incision midurethral slings

Objective: The objective of the study was to evaluate the anatomic relationships of anchor points of single-incision midurethral slings with 2 common placement trajectories. Study Design: In 30 female pelvic halves, a probe was introduced through a suburethral tunnel following 45^° and 90^° angle trajectories. The corresponding anchor points were tagged. Distances to the obturator canal, accessory obturator vessels, dorsal vein of clitoris, and external iliac vein were recorded. Results: Both suburethral tunnel trajectories and their respective anchor points remained caudad to the obturator internus muscle in 100% of dissections. The closest distance between either anchor point to the obturator canal was 1.6 cm. The closest distance from the 45^° and 90^° anchor points to the accessory obturator vessels was 1.6 and 1.5 cm, respectively. Conclusion: The anchor points of single-incision midurethral slings are in close proximity to vascular structures that could be injured with inadvertent entry into the retropubic space.