Intraligamentous nerves as a potential source of pain after sacrospinous ligament fixation of the vaginal apex.
The aim of the study was to investigate the histology of the sacrospinous ligament to determine whether nerve fibers exist within the substance of the sacropinous ligament itself. Six sacrospinous ligaments were removed from 4 fixed female cadavers. Representative segments were taken from the lateral (ischial), middle and medial (sacral) portions of these specimens, sectioned by microtome, mounted, and stained with hematoxylin and eosin dyes. The fixed and stained sections were then examined using light microscopy. Nerve tissue was found to be concentrated in the medial portions of the sacrospinous ligaments, but nerves were found in all segments of the ligament. It was concluded that, nervous tissue is present and widely distributed within the body of the sacrospinous ligament. A wide variety of sizes and thicknesses are also demonstrated, suggesting a variety of functions, including possible pain reception. This fact should be taken into consideration when planning operative procedures for pelvic prolapse.
Barksdale
P A
PA
Louisiana State University Medical Center, New Orleans, USA.
Gasser
R F
RF
Gauthier
C M
CM
Elkins
T E
TE
Wall
L L
LL
D002102:Cadaver; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008022:Ligaments / Q000294:innervation*; D010149:Postoperative Pain / Q000209:etiology*; D017699:Pelvic Pain / Q000209:etiology*; D012447:Sacrum / Q000601:surgery; D013131:Spine / Q000601:surgery; D013537:Sutures