The Suspensory Apparatus of the Female Bladder Neck

Abstract

Lateral cystourethrograms have shown a forwards-downwards displacement of the bladder neck in bladder base insufficiency, a type of stress incontinence. In search for the structure which in normal subjects prevents this displacement, a series of 10 dissections of the female pelvic floor was undertaken. The formerly described structures: The pubo-vesical ligaments and the precervical arc are shown. As a new finding it is demonstrated how these structures are dependent on an upwards-backwards suspension by a strong ligament in the fascia over the levator muscle.