[Anatomical study of Cooper's ligament. Value in the surgical cure of urinary incontinence in women].

The objective of the study was to measure Cooper's ligament thickness in the middle and at 1, 2, 3, 4 cm and to find the best place to fix the stitches of colposuspension. This study was performed on fresh cadavers. Sixteen Cooper's ligaments were studied (8 women, mean age 78 +/- 6 years). The length, the width and thickness of Cooper's ligament at 0, 1, 2, 3, 4 cm from the middle were measured. The limits of Cooper's ligament are indefinite. This ligament is significantly thicker (p < 0.01) in the middle and at 4 cm from the middle (2.2 +/- 0.4 mm) than 1 cm (1.4 +/- 0.5), 2 cm (1.4 +/- 0.5 mm) and at 3 cm (1.9 +/- 0.3 mm) from the middle. Cooper's ligament is used to fix the stitches for colposuspension derived from Burch colposuspension (non-incision percutaneous colposuspension to Cooper's ligament, laparoscopic colposuspension...) and sometime help to fix meshes in frondes procedures and the vagina in the Bologna procedure. This study showed the best point to fix the stitches (by its thickness) for colposuspension on this ligament at 4 cm from the middle (the fixation at the origin exposing to periostitis).