Lahodny J
Abteilung für Gynäkologie und Geburtshilfe, Allgem. öffentl. Krankenhaus St. Pölten.
Geburtshilfe Frauenheilkd. 1988 Jun;48(6):409-13. doi: 10.1055/s-2008-1036003.
The medial pubourethral ligament and the posterior pubourethral ligaments have the important task (for continence) of fixing the neck of the bladder. If the neck of the bladder is placed in relationship to height of the posterior wall of the symphisis, viscerographic examinations show that the neck of the bladder is high in 9% of cases, medium-high in 26%, and low in 65%. When performing reconstructive surgery following detachment of the neck of the bladder as a result of abdominal pressure, these topographic-anatomic features can only be taken into consideration if the primary, original site of the neck of the bladder is known. Intraoperative exposure of the ligament insertion and of the posterior pubourethral ligaments will always permit the primary location of the neck of the bladder to be determined. This is situated 2.3 cm beneath the insertion, and joining the medial ligament to the dorsal urethra will guarantee normal repositioning of the neck of the bladder. If the primary location of the neck of the bladder is unknown in the individual case being treated, the deep tissue pad which develops subsequent to anterior colporraphy corresponds to a nonspecific tissue accumulation with incalculable outcome.
耻骨尿道内侧韧带和耻骨尿道后韧带承担着固定膀胱颈（对控尿而言）的重要任务。若将膀胱颈与耻骨联合后壁的高度关系进行分析，脏器造影检查显示，膀胱颈位置高的情况占9%，中等偏高的占26%，位置低的占65%。当因腹压导致膀胱颈分离后进行重建手术时，只有在知晓膀胱颈的原始位置的情况下，才能考虑这些地形解剖特征。术中暴露韧带附着点和耻骨尿道后韧带总能确定膀胱颈的原始位置。其位于附着点下方2.3厘米处，将内侧韧带与尿道背侧相连可确保膀胱颈正常复位。如果在正在治疗的个体病例中膀胱颈的原始位置未知，那么前阴道壁修补术后形成的深部组织垫相当于一种非特异性组织堆积，其结果难以估量。
