Abstract
Objective: To determine the variation in vaginal axis and posterior cul-de-sac depth when the lowest suture used to attach the sacrocolpopexy mesh to the anterior longitudinal ligament is anchored at different levels. Study Design: At five lumbosacral mesh attachment sites, the anterior vaginal wall axis angle was measured relative to a line between the lowest border of the pubic symphysis and fourth sacral (S4) foramen in 9 unembalmed cadavers. The vertical distance from S4 to the posterior mesh was measured as a surrogate of cul-de-sac depth. Results: From a mesh fixation point at the lower border of S2 to a point at the lower border of L5, there was a 3-fold increase in both vaginal axis angle (13.04 ± 3.19 vs 42.88 ± 4.16 cm) and distance from S4 to the posterior mesh (2.50 ± 0.61 vs 7.38 ± 1.30 cm) between these points. Conclusion: During sacrocolpopexy, progressively cephalad sacral attachment increases vaginal axis angle and cul-de-sac depth.
Original language | English (US) |
---|---|
Pages (from-to) | 488.e1-488.e6 |
Journal | American journal of obstetrics and gynecology |
Volume | 208 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2013 |
Keywords
- posterior cul-de-sac
- sacrocolpopexy
- vaginal axis
ASJC Scopus subject areas
- Obstetrics and Gynecology