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A study of pelvic ligament strength
Michel Cosson1, Malik Boukerrou, Sophie Lacaze
1Pôle de Chirurgie Gynécologique, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire de Lille, 59037 Lille, France. m-cosson@chru-lille.fr
Summary
Pelvic ligament strength varies greatly between individuals and ligament types, impacting prolapse and incontinence surgery success. Subjective evaluation correlates with objective measurements, aiding surgical decisions.
Area of Science:
- Anatomical biomechanics
- Surgical anatomy
Background:
- Pelvic ligaments are crucial for treating pelvic organ prolapse and urinary incontinence.
- Limited data exists on the biomechanical properties of these ligaments.
Purpose of the Study:
- To quantify the tearing strength of key pelvic ligaments used in reconstructive surgery.
- To assess the influence of storage conditions on ligament strength.
Main Methods:
- Tear strength of pelvic ligaments (iliopectineal, sacrospinous, arcus tendineus) from 29 female cadavers was measured using a force gauge.
- Ligaments were categorized subjectively (Groups A, B, C) based on visual and tactile assessment.
- Cadavers were stored frozen, fresh, or in formalin.
Main Results:
- Significant variability in tearing strength (20N-200N) was observed between individuals and ligament types.
- The pre-vertebral ligament was strongest on average.
- Subjective assessments of ligament quality correlated with objective strength measurements.
Conclusions:
- High variability in pelvic ligament strength may contribute to surgical intervention failures.
- Per-operative subjective evaluation can guide the selection of appropriate ligaments for surgical suspension.
- Freezing does not compromise pre-vertebral ligament strength.