INTRODUCTION AND HYPOTHESIS: The objective was to describe the fixation site of the anchor of the Ajust mid-urethral minisling. METHODS: This cadaveric study was based on a group of 11 formalin-embalmed bodies with legs positioned in 30° flexion and 30° abduction, and a group of five fresh-frozen bodies with legs positioned as normal during the procedure. The groups were later compared. The fixation site was dissected and described. The distance to the obturator bundle was considered as the primary safety parameter. To compare the groups of fresh-frozen bodies and formalin-embalmed bodies, the Student's t test and Mann-Whitney test were used. RESULTS: In the group of formalin-embalmed bodies the mean distance from the anchoring device to the obturator nerve was 4.23 cm. In 19 cases out of 22 the anchor was within the complex of the obturator membrane and obturator muscles. In the group of fresh frozen bodies the mean distance to the obturator nerve was 3.15 cm. In 9 cases out of 10 the anchor was in the complex of the obturator membrane and obturator muscles. CONCLUSION: The distance from the anchor to the obturator nerve was more than 2 cm in all cases. Correct placement in the obturator membrane was achieved in 65.6 % of cases. In 87.5 % of cases the anchor was placed within the complex of obturator membrane and obturator muscles.

• MeSH
• balzamování MeSH
• disekce MeSH
• implantace protézy metody   MeSH
• kryoprezervace MeSH
• lidé MeSH
• mrtvola MeSH
• nervus obturatorius anatomie a histologie   MeSH
• pánev anatomie a histologie   MeSH
• polohování pacienta MeSH
• retence protézy * MeSH
• suburetrální pásky * MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: Pelvic lymphadenectomy is an integral component of gynecologic cancer surgery, yet there is a lack of standardization in the terminology used, the extent of the procedure, and the definition of anatomic landmarks. This lack of standardization if corrected will likely facilitate a more clear communication and analysis of outcomes from various institutions, and reduce confusion to trainees about the procedure being performed. METHODS: We summarize the anatomic data concerning pelvic lymphatic drainage; describe the procedure based on clearly defined anatomic landmarks; and finally propose a new classification system to facilitate standardization, communication, and comparison of results. The accompanying video demonstrates the anatomic landmarks. RESULTS: We list and define four commonly used terms related to pelvic lymph node harvesting: sentinel node mapping, excision of bulky nodes, pelvic lymph node sampling, and systematic pelvic lymphadenectomy. We list the five specific anatomic regions of the pelvic lymphatic basin: external iliac, obturator, internal iliac, common iliac, and presacral. We highlight the important neural structures located in regions of the pelvic lymphadenectomy: genitofemoral nerve, obturator nerve, cranial part of the lumbosacral plexus, hypogastric plexus, and splanchnic nerves. Finally, we propose a new, four-part classification system of types of pelvic lymph node dissection. CONCLUSION: In this report and video, we demonstrate anatomy and offer a new classification system for pelvic lymphadenectomy.

• MeSH
• lidé MeSH
• lymfadenektomie klasifikace   metody   normy   MeSH
• lymfatické uzliny anatomie a histologie   patologie   chirurgie   MeSH
• nádory děložního čípku patologie   chirurgie   MeSH
• pánev anatomie a histologie   chirurgie   MeSH
• terminologie jako téma MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Pelvic floor muscles have potential to influence relative pelvic alignment. Side asymmetry in pelvic floor muscle tension is claimed to induce pelvic malalignment. However, its nature and amplitude are not clear. There is a need for non-invasive and reliable assessment method. An intervention experiment of unilateral pelvic floor muscle activation on healthy females was performed using image data for intra-subject comparison of normal and altered configuration of bony pelvis. METHODS: Sequent magnetic resonance imaging of 14 females in supine position was performed with 1.5 T static body coil in coronal orientation. The intervention, surface functional electrostimulation, was applied to activate pelvic floor muscles on the right side. Spatial coordinates of 23 pelvic landmarks were localized in each subject and registered by specially designed magnetic resonance image data processing tool (MPT2006), where individual error calculation; data registration, analysis and 3D visualization were interfaced. FINDINGS: The effect of intervention was large (Cohen's d=1.34). We found significant differences in quantity (P<0.01) and quality (P=0.02) of normal and induced pelvic displacements. After pelvic floor muscle activation on the right side, pelvic structures shifted most frequently to the right side in ventro-caudal direction. The right femoral head, the right innominate and the coccyx showed the largest displacements. INTERPRETATION: The consequences arising from the capacity of pelvic floor muscles to displace pelvic bony structures are important to consider not only in management of malalignment syndrome but also in treatment of incontinence. The study has demonstrated benefits associated with processing of magnetic resonance image data within pelvic region with high localization and registration reliability.

• MeSH
• dospělí MeSH
• interpretace obrazu počítačem metody   MeSH
• kosterní svaly anatomie a histologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• pánev anatomie a histologie   MeSH
• pánevní dno anatomie a histologie   MeSH
• subtrakční technika * MeSH
• vylepšení obrazu metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

A total of 270 muscles, 45 of each of the six individual muscles studied (the sartorius m., the gracilis m., the semitendinous m., the semimembranous m., the greatest gluteal m., the internal obturator m.) were followed up with the aim of evaluating their length parameters and blood and nerve supply. The aim of the study has been to choose the muscle most suitable for transposition and reconstruction of the neosphincter. From the point of view of their anatomy, the internal obturator muscle has been found the most suitable for the purpose.

• MeSH
• anální kanál chirurgie   MeSH
• kosterní svaly anatomie a histologie   krevní zásobení   inervace   transplantace   MeSH
• lidé MeSH
• pánev anatomie a histologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: To describe vaginal support levels according to the DeLancey's classification, their appearance in transversal magnetic resonance images and clinical categories caused by their defects. DESIGN: Review. SETTING: Department of Obstetrics and Gynecology, 1st Medical Faculty, Charles University, Prague; Department of Radiodiagnostics, Charles University, Medical Faculty in Hradec Králové. METHODS: A review of literature, examinations of female pelvis with magnetic resonance imaging (MRI) and 3 dimensional computer reconstructions were made. RESULTS: We performed 20 MRI studies and 5 computer spatial reconstructions of female pelvis. Selected results of a review of literature and our MRI examinations were correlated with various types of vaginal descensus. CONCLUSIONS: The questions about the supporting structures of female vagina are still not fully answered. Great advance was achieved by some recent pathological studies and by the introduction of modern magnetic resonance units in this field. The DeLancey's classification goes well in accord with clinical examination, imaging methods and cadaver studies.

• MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• pánev anatomie a histologie   MeSH
• počítačová rentgenová tomografie MeSH
• počítačové zpracování obrazu MeSH
• svaly anatomie a histologie   MeSH
• vagina anatomie a histologie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH

The prolapse of vaginal stub occurs in about 4% of hysterectomised patients. Suspension of vaginal stub on the ligamentum sacrospinale dextrum is an effective method of the surgical management. The vaginal approach puts increased demands on handiness and orientation in the operation field. Using a proper operation technique and perfect knowledge of the anatomic situation in fossa ischiorectalis can minimize the increased risk of bleeding during the fixation, which results from frequent and varied anastomoses of pelvic vessels. The authors measured several parameters on the group of pelvic girdles of 32 females and found following results: the distance between the base and the apex of spina ischiadica (17.1 mm); the distance between spina ischiadica and the lateral margin of the os sacrum in the axis of central fibres of ligamentum sacrospinale (29.8 mm); the length of axial fibres of ligamentum sacrospinale (37.2 mm); the longest (11.2 mm) and the shortest (1.3 mm) diameter of 15 mm from the top of spina ischiadica. In this site the thickness of muscular layer of musculus coccygeus (3.2 mm) has also been measured. The anatomic study can facilitate the introduction and implementation of more complex surgical techniques.

• MeSH
• dospělí MeSH
• gynekologické chirurgické výkony metody   MeSH
• hysterektomie * MeSH
• lidé MeSH
• pánev anatomie a histologie   MeSH
• pooperační komplikace chirurgie   MeSH
• prolaps dělohy etiologie   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• anální kanál chirurgie   MeSH
• lidé MeSH
• metody MeSH
• pánev anatomie a histologie   MeSH
• rektum chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• antropometrie MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• pánev anatomie a histologie   MeSH
• tělesná námaha MeSH
• tělovýchovné lékařství * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• pánev anatomie a histologie   MeSH
• pelvimetrie MeSH
• sporty * MeSH
• věkové faktory MeSH
• vývoj kostí MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• císařský řez MeSH
• komplikace porodu diagnóza   MeSH
• lidé MeSH
• metody MeSH
• pánev anatomie a histologie   MeSH
• prognóza MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH