Anatomical relationship and fixation of tension-free vaginal tape Secur.
OBJECTIVE
The objective is to describe the anatomical localisation of tension-free vaginal tape Secur (TVT-S) in the H-position regarding possible injury of vessels and fixation site.


METHODS
We placed TVT-S inserters bilaterally in 14 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle (obturator nerve and obturator vessels).


RESULTS
In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 3.05 cm (standard deviation (SD) 1.18 cm) on the left, 3.07 cm (SD 1.17 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 46.4%. In fresh frozen bodies, results were fundamentally similar. Injury of variable vessels can occur.


CONCLUSIONS
There is a minimal risk of injury to the obturator bundle during TVT-S; however, there is a significant risk of inserting the TVT-S inserter into the obturator fossa. The position of TVT-S does not change significantly after legs mal-positioning.
Hubka
Petr
P
First Faculty of Medicine and General Teaching Hospital, Department of Gynaecology and Obstetrics, Charles University in Prague, Apolinarska 18, 12000, Prague, Czech Republic. petr.hubka@vfn.cz
Masata
Jaromir
J
Nanka
Ondrej
O
Grim
Milos
M
Martan
Alois
A
Zvarova
Jana
J
D016063:Blood Loss, Surgical; D002102:Cadaver; D005260:Female; D006801:Humans; D011187:Posture; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D053825:Suburethral Slings