ArticleInternational urogynecology journal2026
A Novel Native Tissue Apical Suspension Procedure Harvesting the Uterosacral Ligament Onto Vaginal Tissue: The NASHUS Cadaver Study.
Article in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- vNOTES retroperitoneal uterosacropexy using the semitendinosus tendon.Obstetrics & gynecology science · 2026Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisThe uterosacral ligaments (USLs) are bilateral deep pelvic support structures used in pelvic floor reconstructive surgery for treatment of apical pelvic organ prolapse (POP). We assessed the feasibility of a new surgical technique using the distal USLs.
methodsFresh frozen un-embalmed female cadavers were studied over a 2-year period (2021 to 2023) to evaluate USL characteristics. The surgical technique involved harvesting the distal USL and applying it to the anterior and posterior cervix. Selected specimens underwent suture pull-out strength testing of the harvested USL, performed using a handheld digital tensiometer device.
resultsTwenty-one specimens underwent laparotomy. Seven had inadequate pelvic access secondary to extensive adhesions or significant pathology. Eleven of the 14 final specimens had a uterus present. Five had evidence of pelvic surgery or disease. The average age was 85 years. USL tissue mass and quality varied; however, it was feasible to perform distal transection of at least one USL in all specimens. Mean harvested USL length was 5.1 cm. Mean distance between the harvested USL to the ipsilateral ureter was 3.5 cm. Applying the harvested USL to the anterior and posterior cervix was possible in all specimens intended for the novel procedure. Specimen supply precluded testing the novel procedure on a vaginal vault. Vaginal suture pull-out mean strength was 12.1 N. Mean abdominal suture pull-out strength was 9.9 N.
conclusionsThe USL is a strong and accessible pelvic support structure. This anatomy-based study demonstrates technical feasibility of our novel apical suspension procedure. Further study of the post-hysterectomy cohort is required.
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