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Am J Obstet Gynecol. 2008 Sep;199(3):242.e1-6. doi: 10.1016/j.ajog.2008.04.003. Epub 2008 May 19.

The lateral infraureteral parametrium: myth or reality?

Author information

1
Department of Obstetrics and Gynecology and Reproductive Medicine, University Saint-Quentin-en-Yvelines, Hôpital de Poissy, Poissy, France.

Abstract

OBJECTIVE:

The objective of the study was to describe the surgical anatomy of infraureteral parametrium.

STUDY DESIGN:

Findings of laparoscopic dissections during 12 type III radical hysterectomies were compared with findings obtained by bilateral pelvic dissections of 5 fresh and 5 embalmed female cadavers and to magnetic resonance imaging of 10 healthy controls.

RESULTS:

Two anatomical entities of the parametrium were distinguished: (1) the lateral mesometrium corresponding to the blade containing vessels and lymph nodes of the uterus; and (2) the infraureteral parametrium extending dorsally from cervix and vagina. The lateral paracervix classically described under the ureter was never identified. Infraureteral parametrium appeared as a fibrous tissue extending in a lateral, dorsal, and caudal direction on both sides of the rectum and very close to the pelvic plexus.

CONCLUSION:

Our results attest to the absence of infraureteral parametrium, raising the issue of the surgical relevance of radical hysterectomy classification and the redefinition of the concept of radical hysterectomy.

PMID:
18486092
DOI:
10.1016/j.ajog.2008.04.003
[Indexed for MEDLINE]

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