The distance between the perceived and the actual arcus tendineus fascia pelvis during vaginal paravaginal repair.
OBJECTIVE
This study was undertaken to determine whether the arcus tendineus fascia pelvis (ATFP) can be accurately identified from the paravaginal space (PVS) without entering the retropubic space (RPS).


METHODS
Eight patients undergoing vaginal paravaginal repair were enrolled. The paravaginal dissection was completed to the most cephalad portion of the PVS without entering the RPS. The apex of each PVS was stained with methylene blue. The RPS was entered, the ATFP visualized, and 4 sutures were placed along its length to be used for the repair. The perpendicular distance between each suture and the most cephalad area of stain was measured.


RESULTS
The mean distance from the perceived to actual ATFP at each suture point (1-4) was 3.5 cm, 2.75 cm, 2.0 cm, and 0.91 cm, respectively.


CONCLUSIONS
In these 8 cases, the RPS had to be entered to accurately identify the ATFP. The degree of error increases as the ischial spine is approached (P < .001).
Claydon
C Sage
CS
Cooper Hospital, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Camden, USA. info@drclaydon.com
Maccarone
Joseph L
JL
Grody
M H Terry
MH
Steinberg
Adam
A
Oyama
Ian
I
Holzberg
Adam S
AS
Caraballo
Ricardo
R
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005205:Fascia / Q000473:pathology*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010388:Pelvis; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013537:Sutures; D014596:Uterine Prolapse / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000601:surgery*