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International Urogynecology Journal
Published in: International Urogynecology Journal 4/2006

01-08-2006 | Original Article

Anatomical study of the obturator foramen and dorsal nerve of the clitoris and their relationship to minimally invasive slings

Authors: Chahin Achtari, Bayden J. Mckenzie, Richard Hiscock, Anna Rosamilia, Lore Schierlitz, Chris A. Briggs, Peter L. Dwyer

Published in: International Urogynecology Journal | Issue 4/2006

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Abstract

Objectives

The objective of the study is to clarify potential risks to the dorsal nerve of the clitoris (DNC) and obturator canal using different minimally invasive slings.

Study design

Ten embalmed hemipelves were dissected to demonstrate the course of the DNC and the obturator canal. On each cadaver, tension-free vaginal tape (TVT), transobturator in–out (TVT-O) and transobturator out–in (Monarc) procedures were performed. Distances between the DNC and the obturator canal to the different devices were measured.

Results

The DNC passes beneath the pubic bone at a distance of 14.3±4.7 mm of the midline. The distances of the different devices to the DNC were similar. The distance to the obturator canal was significantly different, with TVT being the furthest (40.1±3.7 mm) and TVT-O the closest (19.3±3.1 mm; p<0.0001).

Conclusion

Given the course of the DNC along the medial aspect of the ischiopubic ramus, the out–in technique may be safer. The in–out technique is the closest to the obturator canal.
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Metadata
Title
Anatomical study of the obturator foramen and dorsal nerve of the clitoris and their relationship to minimally invasive slings
Authors
Chahin Achtari
Bayden J. Mckenzie
Richard Hiscock
Anna Rosamilia
Lore Schierlitz
Chris A. Briggs
Peter L. Dwyer
Publication date
01-08-2006
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 4/2006
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-005-0004-7

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