title: The distance between the perceived and the actual arcus tendineus fascia pelvis during vaginal paravaginal repair.
abstract: 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).
authors.affiliation: Cooper Hospital, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Camden, USA. info@drclaydon.com
authors.forename: C Sage
authors.initials: CS
authors.lastname: Claydon
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Maccarone
authors.forename: M H Terry
authors.initials: MH
authors.lastname: Grody
authors.forename: Adam
authors.initials: A
authors.lastname: Steinberg
authors.forename: Ian
authors.initials: I
authors.lastname: Oyama
authors.forename: Adam S
authors.initials: AS
authors.lastname: Holzberg
authors.forename: Ricardo
authors.initials: R
authors.lastname: Caraballo
mesh_terms: 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*