Anatomic relationships of the distal third of the pelvic ureter, trigone, and urethra in unembalmed female cadavers.
OBJECTIVE
The objective of the study was to examine the relationship of the ureter to paravaginal defect repair (PVDR) sutures and to evaluate the anatomy of distal ureter, trigone, and urethra relative to the anterior vaginal wall.


METHODS
Dissections of the retropubic space were performed in 24 unembalmed female cadavers following placement of PVDR sutures. Lengths of the vagina, urethra, and trigone were recorded.


RESULTS
The mean distance between apical PVDR sutures and the ureter was 22.8 (range, 5-36) mm. The average lengths of the urethra, trigone, and vagina were 3 cm, 2.8 cm, and 8.4 cm, respectively. The trigone was positioned over the middle third of the anterior vaginal wall in all specimens and the distal ureters traversed the anterolateral vaginal fornices.


CONCLUSIONS
The ureters may be injured during paravaginal defect repairs, anterior colporrhaphies, and other procedures involving dissection in the upper third of the vagina. Cystotomy during vaginal hysterectomies is most likely to occur 2-3 cm above the trigone.
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
David D
DD
Rahn
April T
AT
Bleich
Clifford Y
CY
Wai
Shayzreen M
SM
Roshanravan
Cecilia K
CK
Wieslander
Joseph I
JI
Schaffer
Marlene M
MM
Corton
D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D013536:Suture Techniques / Q000009:adverse effects*; D014513:Ureter / Q000033:anatomy & histology*; D014521:Urethra / Q000033:anatomy & histology*; D001743:Urinary Bladder / Q000033:anatomy & histology*; D014621:Vagina / Q000033:anatomy & histology*