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Anatomy of the arcus tendineus fasciae pelvis in females
Author(s) -
Pit Maarten J.,
De Ruiter Marco C.,
Lycklama À Nijeholt August A.B.,
Marani Enrico,
Zwartendijk Jaap
Publication year - 2003
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.10102
Subject(s) - anatomy , medicine , cadaver , pubic symphysis , pelvis , urethra , gross anatomy , fascia
Because of its proximity to the urethra, the anterior part of the arcus tendineus fasciae pelvis (ATFP) may be used in urethrosuspension procedures for urinary stress incontinence. In this study, 10 embalmed female cadaver hemipelves were dissected and their gross anatomy described. In females, the ATFP is a condensation of the endopelvic fascia. The anterior attachment of the ATFP is to the caudal inner surface of the body of the pubic bone at a site averaging 4 mm lateral to the pubic symphysis and covering an average area of 53 mm 2 . Posteriorly, it attaches to the medial surface of the ischial spine. In nine of the 10 hemipelves the first anterior centimeters of the ATFP have a clear lateral fixation either to the lateral part of the levator ani muscle ( n = 1), to the fascia covering the obturator internus muscle ( n = 7), or to the obturator membrane ( n = 1). Medially from the ATFP derives a 2–3‐cm long flat fibrous attachment to the posterolateral aspect of the urethra. In eight unembalmed cadavers, the ATFP gave way at a pulling force of 8.2 kg (range = 3.5–11.5 kg). The ATFP resists caudal movement of the proximal anterior vaginal wall and the urethra in the upright posture and, therefore, may be suitable for urethrosuspension procedures. Clin. Anat. 16:131–137, 2003. © 2003 Wiley‐Liss, Inc.