Fixation of the Ajust minisling based upon cadaveric study

Area of Science:

• Urology
• Anatomy
• Surgical Procedures

Background:

• Urinary incontinence is a common condition affecting many women.
• Mid-urethral slings are a common surgical treatment for stress urinary incontinence.
• Understanding the precise anatomical fixation of sling anchors is crucial for surgical safety and efficacy.

Purpose of the Study:

• To anatomically describe the fixation site of the Ajust mid-urethral minisling anchor.
• To evaluate the safety of the anchor placement relative to the obturator nerve and bundle.

Main Methods:

• Cadaveric study using formalin-embalmed and fresh-frozen body groups.
• Dissection and description of the anchor fixation site.
• Measurement of the distance from the anchor to the obturator nerve as a primary safety parameter.
• Statistical comparison between the two body groups using Student's t test and Mann-Whitney test.

Main Results:

• In formalin-embalmed bodies, the mean distance to the obturator nerve was 4.23 cm; 81.8% of anchors were within the obturator membrane/muscles complex.
• In fresh-frozen bodies, the mean distance to the obturator nerve was 3.15 cm; 90% of anchors were within the obturator membrane/muscles complex.
• The anchor was consistently placed more than 2 cm from the obturator nerve in all specimens.

Conclusions:

• The Ajust minisling anchor demonstrates a safe fixation site, consistently positioned distant from the obturator nerve.
• Accurate placement within the obturator membrane complex was achieved in a high percentage of cases (65.6% to 87.5%).
• These findings support the anatomical safety of the Ajust mid-urethral minisling anchor placement.