de la Taille A, Delmas V, Lassau J P, Boccon-Gibod L
Institut d'Anatomie, UFR Biomédicale des Saints Pères, Paris, France.
Prog Urol. 1997 Sep;7(4):604-10.
In 1963, the studies by Zacharin emphasized the importance of the suspensory apparatus of the female urethra, consisting of two non-extensible fibrous bands composed of 3 distinct ligaments. The objectives of this study were to evaluate the role of these ligaments in support of the urethra and to define the value of their preservation in cystectomy with bladder replacement in women.
Five fresh female cadavres with a mean age 78 years (range: 75-82) were used for dissection of the suspensory apparatus of the urethra via a suprapubic then sagittal approach by section of the pelvis 2 cm from the midline. Histological studies of the urethra were then performed.
The suspensory apparatus of the urethra was found to be a paired, symmetrical system composed of 2 paired and symmetrical fibrous bands. Dissection of these bands revealed three anterior, intermediate and posterior pubourethral ligaments. The posterior pubourethral ligament was inserted on the anterior and lateral surfaces of the urethra and vagina (underneath the bladder neck) on anatomical studies, but also on histological sections. Section of the posterior pubourethral ligament allowed great mobility of half of the urethra. Section of these ligaments totally released the urethra from the pubis.
Our study confirmed the importance of this ligamentous system in suspension of the urethra and demonstrated the value of preservation of these structures in cystectomy with bladder replacement in women.
1963年，扎查林的研究强调了女性尿道悬韧带装置的重要性，该装置由两条不可伸展的纤维带组成，这两条纤维带由3条不同的韧带构成。本研究的目的是评估这些韧带在支撑尿道方面的作用，并确定在女性膀胱替代膀胱切除术时保留这些韧带的价值。
使用5具平均年龄78岁（范围：75 - 82岁）的新鲜女性尸体，通过耻骨上然后矢状位入路，在距中线2 cm处切开骨盆，对尿道悬韧带装置进行解剖。然后对尿道进行组织学研究。
发现尿道悬韧带装置是一个由2条成对且对称的纤维带组成的成对、对称系统。对这些纤维带进行解剖后发现有三条耻骨尿道前韧带、中间韧带和后韧带。解剖学研究以及组织学切片显示，耻骨尿道后韧带附着于尿道和阴道（膀胱颈下方）的前表面和外侧表面。切断耻骨尿道后韧带会使尿道的一半具有很大的活动度。切断这些韧带会使尿道完全从耻骨上松解下来。
我们的研究证实了这个韧带系统在尿道悬吊中的重要性，并证明了在女性膀胱替代膀胱切除术时保留这些结构的价值。
