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The Ureter as a Landmark for Robotic Sacrocolpopexy

McCullough, Mona MD, ME; Valceus, Jessica; Downes, Katheryne MPH; Hoyte, Lennox MD, MSEECS

Female Pelvic Medicine & Reconstructive Surgery: May/June 2012 - Volume 18 - Issue 3 - p 162–164
doi: 10.1097/SPV.0b013e3182544e17
Original Articles

Objective The objective of this study was to report on the location of the ureters in relation to the sacral promontory at the level of the pelvic brim.

Methods Female patients undergoing indicated computed tomographic (CT) urograms were selected for this study. Charts and images from a defined 3-year study period were reviewed. The GE Centricity software was used to evaluate multiplanar CT views and measure the distance from the bilateral ureters to the midpoint of the distal sacral promontory for each subject.

Results Sixty-three women underwent CT urography during the study period. Of these, 38 met the criteria for inclusion. Among these, the left ureter was 35.9 ± 4.9 mm lateral to the midsacral promontory. The right ureter was 29.7 ± 6.2 mm lateral to the sacral promontory.

Conclusions On average, the sacral promontory is located 29.7 mm medial to the right ureter at the level of the pelvic brim. This represents a landmark that may prove clinically useful, along with other visual cues, in choosing the proper location for careful dissection toward the anterior longitudinal ligament during robotic sacrocolpopexy.

This IRB-approved retrospective study of 38 female CT-urograms describes a positional relationship between the ureters and sacral promontory, which may assist landmark localiztion when direct robotic visualization of the promontory is obscured.

From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL.

Reprints: Mona C. McCullough MD, ME, 2 Tampa General Circle, 6th Floor, Tampa, FL 33606. E-mail:

No funding was received for this study.

The authors declare that they have nothing to disclose.

© 2012 by Wolters Kluwer Health | Lippincott Williams & Wilkins