Variability of the retropubic space anatomy in female cadavers

Objective

To characterize the anatomic relationships of clinically relevant structures in the retropubic space.

Study Design

Detailed dissections were performed in 15 female cadavers.

Results

The obturator vein was the closest of the obturator neurovascular structures to the ischial spine, median distance 3.4 cm (range, 1.8–4.8 cm). The vesical venous plexus included 2-5 rows of veins that coursed within the paravaginal tissue parallel to the bladder and drained into the internal iliac veins. The internal iliac vein was formed cephalad to the level of the ischial spine; the closest distance between these structures was 3.8 cm (1.6-6.2 cm).

Conclusion

The complexity and proximity of the large internal iliac venous system to the bony landmarks used for passage of trocars is described in this study. A thorough understanding of the vascular anatomy in this space should help avoid serious operative complications.

Key words: internal iliac vein, retropubic space, vesical venous plexus