title: The dorsal nerve of the clitoris in relation to urinary incontinence sling procedures.
abstract: OBJECTIVE
  To avoid injury to the perineal branches of the pudendal nerve during urinary incontinence sling procedures, a thorough knowledge of the course of these nerve branches is essential. The dorsal nerve of the clitoris (DNC) may be at risk when performing the retropubic (tension-free vaginal tape) procedure as well as the inside-out and outside-in transobturator tape procedures. The purpose of this study was to identify the anatomical relationships of the DNC to the tapes placed during the procedures mentioned and to determine the influence of body variations.
  
  
  METHODS
  In this cadaveric study, the body mass index (cBMI) of unembalmed cadavers was determined. Suburethral tape procedures were performed by a registered urologist and gynecologist on a sample of 15 female cadavers; six retropubic, seven inside-out and nine outside-in transobturator tapes were inserted. After embalmment, dissections were performed and the distances between the DNC and the tapes measured.
  
  
  RESULTS
  In general the trajectory of the outside-in tape was closer to the DNC than that of the other tapes. cBMI was weakly and nonsignificantly correlated with the distance between the trajectory of the tape and the DNC for the inside-out tape and the tension-free vaginal tape, but not for the outside-in tape.
  
  
  CONCLUSIONS
  The findings suggest that the DNC is less likely to be injured during the inside-out tape procedure than during the outside-in procedure, regardless of BMI. Future studies on larger samples are desirable to confirm these findings.
authors.affiliation: Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia, Pretoria, 0007, Republic of South Africa. duplessis.son@gmail.com.|Department of Anatomy, School of Pathology and Pre-Clinical Sciences, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Gauteng, South Africa. duplessis.son@gmail.com.
authors.forename: Sonè
authors.initials: S
authors.lastname: van der Walt
authors.affiliation: Department of Urology, Urology Hospital, Pretoria, Gauteng, South Africa.
authors.forename: Frans J
authors.initials: FJ
authors.lastname: van Wijk
authors.affiliation: University of Pretoria, Gauteng, South Africa.
authors.forename: Zeelha
authors.initials: Z
authors.lastname: Abdool
authors.affiliation: Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Arcadia, Pretoria, 0007, Republic of South Africa.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Oettlé
mesh_terms: D002102:Cadaver; D002987:Clitoris / Q000294:innervation / Q000601:surgery; D005260:Female; D006801:Humans; D060525:Pudendal Nerve / Q000033:anatomy & histology / Q000601:surgery*; D053825:Suburethral Slings; D014549:Urinary Incontinence / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
keywords: Body mass index; Pudendal nerve; Retropubic tape; Transobturator tape