APPLIED ASPECTS OF TOPOGRAPHICANATOMICAL INTERRELATIONS OF FEMALE PELVIC ORGANS AND CELLULAR SPACES

The study of an autopsy material, obtained from females aged 15–74 years (145 organ complexes), using the classical anatomical research methods, resulted in the topographic-anatomical substantiation of transvaginal surgical accesses to subperitoneal and peritoneal pelvic floors taking into account the variants of the uterus position. The projection-syntopic correlations of subperitoneal and peritoneal structures with vaginal fornix were examined, the latter was divided for this purpose into the limited areas — vaginal segments. It was found that the transvaginal accesses in the uterus position of the anteversio-anteflexio and retroversio-retroflexio (with more common symmetrical relations between the pelvic structures and vaginal fornix), should be performed in the projection of vaginal segments 10.5–1.5 and 5.5–6.5. Due to asymmetric projection-syntopic relations of subperitoneal and peritoneal pelvic structures with vaginal fornix, the optimal accesses are recommended in the projection of vaginal segments 12–1.5, 11.5–2 and 6–6.5 in sinistroversio, sinistropositio with a clockwise uterine rotation, while in dextropositio and counterclockwise uterine rotation, the accesses in the projection of vaginal segments 10.5–12, 10.5–1, 6–5.5 and 6–5 are preferable.

female pelvis, uterus, vaginal fornix, uterine artery, the ureters