Lowest colpopexy sacral fixation point alters vaginal axis and cul-de-sac depth

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7 Citations (Scopus)

Abstract

Objective: To determine the variation in vaginal axis and posterior cul-de-sac depth when the lowest suture used to attach the sacrocolpopexy mesh to the anterior longitudinal ligament is anchored at different levels. Study Design: At five lumbosacral mesh attachment sites, the anterior vaginal wall axis angle was measured relative to a line between the lowest border of the pubic symphysis and fourth sacral (S4) foramen in 9 unembalmed cadavers. The vertical distance from S4 to the posterior mesh was measured as a surrogate of cul-de-sac depth. Results: From a mesh fixation point at the lower border of S2 to a point at the lower border of L5, there was a 3-fold increase in both vaginal axis angle (13.04 ± 3.19 vs 42.88 ± 4.16 cm) and distance from S4 to the posterior mesh (2.50 ± 0.61 vs 7.38 ± 1.30 cm) between these points. Conclusion: During sacrocolpopexy, progressively cephalad sacral attachment increases vaginal axis angle and cul-de-sac depth.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume208
Issue number6
DOIs
StatePublished - Jun 2013

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Pubic Symphysis
Longitudinal Ligaments
Cadaver
Sutures

Keywords

  • posterior cul-de-sac
  • sacrocolpopexy
  • vaginal axis

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

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title = "Lowest colpopexy sacral fixation point alters vaginal axis and cul-de-sac depth",
abstract = "Objective: To determine the variation in vaginal axis and posterior cul-de-sac depth when the lowest suture used to attach the sacrocolpopexy mesh to the anterior longitudinal ligament is anchored at different levels. Study Design: At five lumbosacral mesh attachment sites, the anterior vaginal wall axis angle was measured relative to a line between the lowest border of the pubic symphysis and fourth sacral (S4) foramen in 9 unembalmed cadavers. The vertical distance from S4 to the posterior mesh was measured as a surrogate of cul-de-sac depth. Results: From a mesh fixation point at the lower border of S2 to a point at the lower border of L5, there was a 3-fold increase in both vaginal axis angle (13.04 ± 3.19 vs 42.88 ± 4.16 cm) and distance from S4 to the posterior mesh (2.50 ± 0.61 vs 7.38 ± 1.30 cm) between these points. Conclusion: During sacrocolpopexy, progressively cephalad sacral attachment increases vaginal axis angle and cul-de-sac depth.",
keywords = "posterior cul-de-sac, sacrocolpopexy, vaginal axis",
author = "Sunil Balgobin and Good, {Meadow M.} and Dillon, {Shena J.} and Corton, {Marlene M.}",
year = "2013",
month = "6",
doi = "10.1016/j.ajog.2013.03.006",
language = "English (US)",
volume = "208",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "6",

}

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T1 - Lowest colpopexy sacral fixation point alters vaginal axis and cul-de-sac depth

AU - Balgobin, Sunil

AU - Good, Meadow M.

AU - Dillon, Shena J.

AU - Corton, Marlene M.

PY - 2013/6

Y1 - 2013/6

N2 - Objective: To determine the variation in vaginal axis and posterior cul-de-sac depth when the lowest suture used to attach the sacrocolpopexy mesh to the anterior longitudinal ligament is anchored at different levels. Study Design: At five lumbosacral mesh attachment sites, the anterior vaginal wall axis angle was measured relative to a line between the lowest border of the pubic symphysis and fourth sacral (S4) foramen in 9 unembalmed cadavers. The vertical distance from S4 to the posterior mesh was measured as a surrogate of cul-de-sac depth. Results: From a mesh fixation point at the lower border of S2 to a point at the lower border of L5, there was a 3-fold increase in both vaginal axis angle (13.04 ± 3.19 vs 42.88 ± 4.16 cm) and distance from S4 to the posterior mesh (2.50 ± 0.61 vs 7.38 ± 1.30 cm) between these points. Conclusion: During sacrocolpopexy, progressively cephalad sacral attachment increases vaginal axis angle and cul-de-sac depth.

AB - Objective: To determine the variation in vaginal axis and posterior cul-de-sac depth when the lowest suture used to attach the sacrocolpopexy mesh to the anterior longitudinal ligament is anchored at different levels. Study Design: At five lumbosacral mesh attachment sites, the anterior vaginal wall axis angle was measured relative to a line between the lowest border of the pubic symphysis and fourth sacral (S4) foramen in 9 unembalmed cadavers. The vertical distance from S4 to the posterior mesh was measured as a surrogate of cul-de-sac depth. Results: From a mesh fixation point at the lower border of S2 to a point at the lower border of L5, there was a 3-fold increase in both vaginal axis angle (13.04 ± 3.19 vs 42.88 ± 4.16 cm) and distance from S4 to the posterior mesh (2.50 ± 0.61 vs 7.38 ± 1.30 cm) between these points. Conclusion: During sacrocolpopexy, progressively cephalad sacral attachment increases vaginal axis angle and cul-de-sac depth.

KW - posterior cul-de-sac

KW - sacrocolpopexy

KW - vaginal axis

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