title: Important anatomical structures used in paravaginal defect repair: cadaveric study.
abstract: OBJECTIVE
  To examine the variations and the anatomical characteristics of the tendinous arch of pelvic fascia (TAPF), the tendinous arch of levator ani (TALA) and the obturator fascia (Ofa) that are important structures in paravaginal defect repair and their relations with important neurovascular structures.
  
  
  METHODS
  We carried our study on 10 pelvic halves of five female cadavers fixed in 10% formaldehyde.
  
  
  RESULTS
  TALA could show a very high location or a low location near to inferior edge of obturator internus. TAPF was not observed in four of the cases. It was examined as a quite weak structure in two of the cases. The location of obturator vessel-nerve bundle could show difference. Obturator artery (OA) and vein sometimes do not course parallel to obturator vein (OV) and make an inclination and extend to the obturator foramen (OF). The distance between TAPF and the pectineal ligament (PL) (Cooper ligament) was measured as 5 cm on average. The distance between TAPF and the entrance of obturator canal was measured as 3.2 cm on average. While the distance of pudendal vessel-nerve bundle from levator ani (LA) at the anterior border of the spine was 0 mm, 2 cm anteriorly it was measured as 4.4 mm on average.
  
  
  CONCLUSIONS
  Since TAPF does not develop in every case, it is not a safe structure to be used in surgery. If TALA develop downward as a variation, it could be difficult to distinguish from TAPF. Since the obturator fascia is a thin membrane, it is not a strong structure for suture placement. The region that is 2 cm in front of the ischial spine (IS) is a dangerous zone for pudendal vessel-nerve bundle.
authors.affiliation: Department of Anatomy, Faculty of Medicine, Kirikkale University, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ersoy
authors.forename: Nevin
authors.initials: N
authors.lastname: Sagsoz
authors.forename: M Cem
authors.initials: MC
authors.lastname: Bozkurt
authors.forename: Nihal
authors.initials: N
authors.lastname: Apaydin
authors.forename: Alaittin
authors.initials: A
authors.lastname: Elhan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Tekdemir
mesh_terms: D000368:Aged; D002102:Cadaver; D005205:Fascia / Q000033:anatomy & histology; D000071938:Fasciotomy; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000033:anatomy & histology / Q000601:surgery; D010502:Perineum / Q000033:anatomy & histology* / Q000601:surgery; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013536:Suture Techniques; D013710:Tendons / Q000033:anatomy & histology / Q000601:surgery; D013718:Tensile Strength; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery