Hubka Petr, Masata Jaromir, Nanka Ondrej, Grim Milos, Martan Alois, Zvarova Jana
First Faculty of Medicine and General Teaching Hospital, Department of Gynaecology and Obstetrics, Charles University in Prague, Apolinarska 18, 12000, Prague, Czech Republic.
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Jun;20(6):681-8. doi: 10.1007/s00192-009-0815-z. Epub 2009 Feb 13.
The objective is to describe the anatomical localisation of tension-free vaginal tape Secur (TVT-S) in the H-position regarding possible injury of vessels and fixation site.
We placed TVT-S inserters bilaterally in 14 embalmed and five fresh frozen female bodies. After dissection, we measured distances from the obturator bundle (obturator nerve and obturator vessels).
In embalmed bodies, the mean distance of TVT-S from the obturator bundle was 3.05 cm (standard deviation (SD) 1.18 cm) on the left, 3.07 cm (SD 1.17 cm) on the right. Perforation of the fascia of obturator internus muscle occurred in 46.4%. In fresh frozen bodies, results were fundamentally similar. Injury of variable vessels can occur.
There is a minimal risk of injury to the obturator bundle during TVT-S; however, there is a significant risk of inserting the TVT-S inserter into the obturator fossa. The position of TVT-S does not change significantly after legs mal-positioning.
目的是描述无张力阴道吊带Secur（TVT-S）在H位时关于血管损伤和固定部位的解剖定位。
我们在14具防腐处理的和5具新鲜冷冻的女性尸体上双侧放置TVT-S插入器。解剖后，我们测量了距闭孔束（闭孔神经和闭孔血管）的距离。
在防腐处理的尸体中，TVT-S距闭孔束的平均距离在左侧为3.05厘米（标准差（SD）1.18厘米），右侧为3.07厘米（SD 1.17厘米）。闭孔内肌筋膜穿孔发生率为46.4%。在新鲜冷冻的尸体中，结果基本相似。可能会发生不同血管的损伤。
TVT-S操作过程中闭孔束损伤风险极小；然而，将TVT-S插入器插入闭孔窝有显著风险。腿部位置不当后TVT-S的位置无明显变化。
