Nerve injury during uterosacral ligament fixation: A cadaver study

Sarah A. Collins*, Sherry A. Downie, Todd R. Olson, Magdy S. Mikhail

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Introduction and hypothesis: The objective of this study was to identify nerve(s) vulnerable to entrapment during uterosacral ligament fixation (USLF), which could cause postoperative lower extremity pain previously described in the literature. Methods: Preserved cadavers in a medical anatomy course were used. Before the students' pelvic dissections, a 2-0 prolene suture was placed in the middle third of each left uterosacral ligament visualized. The sutures were re-evaluated at the end of the course. Results: Nine sutures remained in place after the course, and one entrapped a nerve. It was part of the inferior hypogastric plexus, included fibers from S2 and S3, and radiated to the bladder and rectum. The posterior femoral cutaneous nerve was lateral and posterior to this nerve. Conclusions: The inferior hypogastric plexus is vulnerable during USLF. Entrapment of S2 and S3 fibers could cause pain in their respective dermatomes and could be responsible for the postoperative pain previously described.

Original languageEnglish (US)
Pages (from-to)505-508
Number of pages4
JournalInternational Urogynecology Journal
Issue number5
StatePublished - 2009


  • Nerve injury
  • Pelvic organ prolapse
  • Uterosacral ligament fixation
  • Vault suspension

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynecology


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