Anatomic relationships of psoas muscle: Clinical applications to psoas hitch ureteral reimplantation

Pedro A. Maldonado, Paul D. Slocum, Kathleen Chin, Marlene M. Corton

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective The objective of the study was to examine the anatomic relationship of the genitofemoral and femoral nerves to the psoas major muscle. Study Design Dissections were performed in 17 unembalmed female cadavers. Point A was used as the approximate location for placement of psoas hitch sutures and as the reference point from which all measurements were taken. Measurements included the width of the psoas major muscle, psoas minor tendon, genitofemoral nerve branches, and femoral nerve. The relative location of the genitofemoral and femoral nerves to point A and the presence or absence of a psoas minor tendon were documented. Results The psoas minor tendon was absent on at least 1 side in 11 specimens (64.7%). The median width of the psoas minor tendon was 7 mm (range, 3-11.5 mm). The median width and depth of the psoas major muscle was 21.5 mm (range, 10-35 mm) and 20.0 mm (range, 11.5-32 mm), respectively. The median width of the genitofemoral nerve was 2 mm (range, 1-4.5 mm) and that of the femoral nerve was 6.3 mm (range, 5-10.5 mm). Overall, 54 genitofemoral nerve branches were identified in 17 cadavers, 30 medial (55.5%), 22 lateral (40.7%), and 2 directly overlying point A (3.7%). Conclusion The exact location for the placement of the psoas hitch sutures will vary, depending on the location of the ureteral injury and the anatomy of the psoas muscle and surrounding structures. A thorough understanding of this regional anatomy should optimize the placement of psoas hitch sutures during ureteral reimplantation procedures and help avoid nerve and vessel injury.

Original languageEnglish (US)
Pages (from-to)563.e1-563.e6
JournalAmerican Journal of Obstetrics and Gynecology
Volume211
Issue number5
DOIs
StatePublished - Nov 1 2014

Fingerprint

Psoas Muscles
Femoral Nerve
Replantation
Tendons
Sutures
Cadaver
Regional Anatomy
Wounds and Injuries
Dissection
Anatomy

Keywords

  • femoral nerve
  • genitofemoral nerve
  • nerve injury
  • psoas hitch
  • ureteral reimplantation

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Anatomic relationships of psoas muscle : Clinical applications to psoas hitch ureteral reimplantation. / Maldonado, Pedro A.; Slocum, Paul D.; Chin, Kathleen; Corton, Marlene M.

In: American Journal of Obstetrics and Gynecology, Vol. 211, No. 5, 01.11.2014, p. 563.e1-563.e6.

Research output: Contribution to journalArticle

@article{87bfbd20ae994005b2be6a80b7d46ad7,
title = "Anatomic relationships of psoas muscle: Clinical applications to psoas hitch ureteral reimplantation",
abstract = "Objective The objective of the study was to examine the anatomic relationship of the genitofemoral and femoral nerves to the psoas major muscle. Study Design Dissections were performed in 17 unembalmed female cadavers. Point A was used as the approximate location for placement of psoas hitch sutures and as the reference point from which all measurements were taken. Measurements included the width of the psoas major muscle, psoas minor tendon, genitofemoral nerve branches, and femoral nerve. The relative location of the genitofemoral and femoral nerves to point A and the presence or absence of a psoas minor tendon were documented. Results The psoas minor tendon was absent on at least 1 side in 11 specimens (64.7{\%}). The median width of the psoas minor tendon was 7 mm (range, 3-11.5 mm). The median width and depth of the psoas major muscle was 21.5 mm (range, 10-35 mm) and 20.0 mm (range, 11.5-32 mm), respectively. The median width of the genitofemoral nerve was 2 mm (range, 1-4.5 mm) and that of the femoral nerve was 6.3 mm (range, 5-10.5 mm). Overall, 54 genitofemoral nerve branches were identified in 17 cadavers, 30 medial (55.5{\%}), 22 lateral (40.7{\%}), and 2 directly overlying point A (3.7{\%}). Conclusion The exact location for the placement of the psoas hitch sutures will vary, depending on the location of the ureteral injury and the anatomy of the psoas muscle and surrounding structures. A thorough understanding of this regional anatomy should optimize the placement of psoas hitch sutures during ureteral reimplantation procedures and help avoid nerve and vessel injury.",
keywords = "femoral nerve, genitofemoral nerve, nerve injury, psoas hitch, ureteral reimplantation",
author = "Maldonado, {Pedro A.} and Slocum, {Paul D.} and Kathleen Chin and Corton, {Marlene M.}",
year = "2014",
month = "11",
day = "1",
doi = "10.1016/j.ajog.2014.07.008",
language = "English (US)",
volume = "211",
pages = "563.e1--563.e6",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Anatomic relationships of psoas muscle

T2 - Clinical applications to psoas hitch ureteral reimplantation

AU - Maldonado, Pedro A.

AU - Slocum, Paul D.

AU - Chin, Kathleen

AU - Corton, Marlene M.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Objective The objective of the study was to examine the anatomic relationship of the genitofemoral and femoral nerves to the psoas major muscle. Study Design Dissections were performed in 17 unembalmed female cadavers. Point A was used as the approximate location for placement of psoas hitch sutures and as the reference point from which all measurements were taken. Measurements included the width of the psoas major muscle, psoas minor tendon, genitofemoral nerve branches, and femoral nerve. The relative location of the genitofemoral and femoral nerves to point A and the presence or absence of a psoas minor tendon were documented. Results The psoas minor tendon was absent on at least 1 side in 11 specimens (64.7%). The median width of the psoas minor tendon was 7 mm (range, 3-11.5 mm). The median width and depth of the psoas major muscle was 21.5 mm (range, 10-35 mm) and 20.0 mm (range, 11.5-32 mm), respectively. The median width of the genitofemoral nerve was 2 mm (range, 1-4.5 mm) and that of the femoral nerve was 6.3 mm (range, 5-10.5 mm). Overall, 54 genitofemoral nerve branches were identified in 17 cadavers, 30 medial (55.5%), 22 lateral (40.7%), and 2 directly overlying point A (3.7%). Conclusion The exact location for the placement of the psoas hitch sutures will vary, depending on the location of the ureteral injury and the anatomy of the psoas muscle and surrounding structures. A thorough understanding of this regional anatomy should optimize the placement of psoas hitch sutures during ureteral reimplantation procedures and help avoid nerve and vessel injury.

AB - Objective The objective of the study was to examine the anatomic relationship of the genitofemoral and femoral nerves to the psoas major muscle. Study Design Dissections were performed in 17 unembalmed female cadavers. Point A was used as the approximate location for placement of psoas hitch sutures and as the reference point from which all measurements were taken. Measurements included the width of the psoas major muscle, psoas minor tendon, genitofemoral nerve branches, and femoral nerve. The relative location of the genitofemoral and femoral nerves to point A and the presence or absence of a psoas minor tendon were documented. Results The psoas minor tendon was absent on at least 1 side in 11 specimens (64.7%). The median width of the psoas minor tendon was 7 mm (range, 3-11.5 mm). The median width and depth of the psoas major muscle was 21.5 mm (range, 10-35 mm) and 20.0 mm (range, 11.5-32 mm), respectively. The median width of the genitofemoral nerve was 2 mm (range, 1-4.5 mm) and that of the femoral nerve was 6.3 mm (range, 5-10.5 mm). Overall, 54 genitofemoral nerve branches were identified in 17 cadavers, 30 medial (55.5%), 22 lateral (40.7%), and 2 directly overlying point A (3.7%). Conclusion The exact location for the placement of the psoas hitch sutures will vary, depending on the location of the ureteral injury and the anatomy of the psoas muscle and surrounding structures. A thorough understanding of this regional anatomy should optimize the placement of psoas hitch sutures during ureteral reimplantation procedures and help avoid nerve and vessel injury.

KW - femoral nerve

KW - genitofemoral nerve

KW - nerve injury

KW - psoas hitch

KW - ureteral reimplantation

UR - http://www.scopus.com/inward/record.url?scp=84908278086&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908278086&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2014.07.008

DO - 10.1016/j.ajog.2014.07.008

M3 - Article

C2 - 25019482

AN - SCOPUS:84908278086

VL - 211

SP - 563.e1-563.e6

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 5

ER -