Petros P E
Royal Perth Hospital, Western Australia.
Int Urogynecol J Pelvic Floor Dysfunct. 1998;9(3):154-7. doi: 10.1007/BF02001085.
The aim of the study was to analyze the structure, relations and insertions of the pubourethral ligament in the living female. Thirty-five women, mean age 44 years, were studied. The intravaginal slingplasty (IVS) procedure, as performed via two paraurethral incisions, allowed immediate access to the structures in this area, the urethra, vaginal hammock, pubourethral ligaments and anterior portion of the pubococcygeus muscle. Histological biopsies were performed from the structures identified as ligaments. The pubourethral ligament descends like a fan from the lower part of the pubic bone. It consists of vaginal and urethral parts, joined together by thin fibrous threads, giving the appearance of a continuous sheet of amorphous connective tissue. Each part generally varies between 5 and 7 mm in width and 3-4 mm in thickness. The urethral part is approximately 2 cm long and inserts into the midpart of the urethra. The vaginal part is approximately 3-4 cm long. It inserts into the vaginal hammock posterolaterally, approximately 1 cm short of the bladder neck. Histologically the ligaments consist of smooth muscle, elastin, collagen, nerves and, blood vessels. The dissections confirm that the pubourethral ligaments are strong finite structures. Allowing for differences between cadavers and live patients, relationships and insertions are much as described by Robert Zacharin.
本研究的目的是分析活体女性耻骨尿道韧带的结构、关系及附着情况。对35名平均年龄44岁的女性进行了研究。经两个尿道旁切口实施的阴道吊带成形术（IVS）能够直接观察该区域的结构，包括尿道、阴道吊带、耻骨尿道韧带和耻骨尾骨肌前部。对确定为韧带的结构进行了组织学活检。耻骨尿道韧带呈扇形从耻骨下部向下延伸。它由阴道部和尿道部组成，通过细纤维束连接在一起，呈现出连续的无定形结缔组织薄片外观。每个部分的宽度一般在5至7毫米之间，厚度为3 - 4毫米。尿道部长约2厘米，附着于尿道中部。阴道部长约3 - 4厘米。它附着于阴道吊带的后外侧，距膀胱颈约1厘米处。组织学检查显示，韧带由平滑肌、弹性蛋白、胶原蛋白、神经和血管组成。解剖结果证实耻骨尿道韧带是坚固的有限结构。考虑到尸体与活体患者之间的差异，其关系和附着情况与罗伯特·扎查林所描述的大致相同。
