[Anatomy and tensile strength of the internal obturator muscle in the framework of a modified technic of the Marshall-Marchetti-Krantz operation]

Abstract

In a modified technique of the cysto-urethropexy the elevation of the vesicle neck is accomplished by suturing the vaginal fascia to the obturator fascia and the internal obturator muscle. In 10 recently deceased female corpses the tensibility of the internal obturator muscle was tested in conditions similar to the modified marshall marchetti krantz technique. The tensibility of the fixation point to the point of tearing out of the suture is in the mean on each side short of 7 Kp. It can be assumed that the tensibility at the fixation point is increased by the contractility of the internal obturator muscle, which among other functions helps to fix the pelvis in the erect body position. In 7 formalin fixed and 3 non-fixed female corpses the thickness of the internal obturator muscle between the fascia and the obturator membrane was measured. In correct operative technique the obturator membrane is not incorporated into the suture since the thickness of the muscle is approximately 7.5 mm. The vessels and nerves in the obturator canal or not touched by the suture as long as the sutures are placed in the medial portion of the muscle. Variations of the arterial blood supply are mentioned.